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Hepatitis E virus infection

Kenneth E Sherman, MD, PhD
Section Editor
Adrian M Di Bisceglie, MD
Deputy Editors
Shilpa Grover, MD, MPH, AGAF
Jennifer Mitty, MD, MPH


Hepatitis E virus (HEV) is one of the most common causes, yet least diagnosed etiologies, of acute viral hepatitis [1]. HEV infection has a global distribution, with distinct differences in transmission and disease outcomes in resource-rich versus resource-limited areas.

This topic will review the epidemiology, clinical manifestations, diagnosis, and treatment of HEV infection in adults. Other causes of viral hepatitis are discussed in detail separately. (See "Hepatitis A virus infection in adults: An overview" and "Clinical manifestations and natural history of hepatitis B virus infection" and "Clinical manifestations and natural history of chronic hepatitis C virus infection".)


Composition and structure — Hepatitis E virus (HEV) is a small, icosahedral, nonenveloped single-stranded RNA virus that is approximately 27 to 34 nm in diameter [2-6]. It has been classified as the single member of the genus Hepevirus in the family Hepeviridae [7]. Three large open reading frames (ORFs) of the positive-sense RNA of HEV have been described [8]:

The largest ORF consists of 1693 codons; it codes for nonstructural proteins that are responsible for the processing and replication of the virus, including a methyltransferase, an RNA helicase, a cysteine protease, and an RNA polymerase [9].

The second ORF is composed of 660 codons and codes for viral capsid structural proteins.

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Literature review current through: Nov 2017. | This topic last updated: Aug 21, 2017.
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