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Abstract Hepatitis E is a viral liver disease caused by the hepatitis E virus (HEV), which is endemic in many tropical countries . Hepatitis E has been considered to be a travel-associated , acute , self-limiting liver disease that only causes fulminant hepatic failure in specific , high-risk groups . HEV genotype 1 is responsible for endemic and epidemic infections by HEV in Asia , while genotype 2 is endemic in Africa and Mexico. These genotypes are usually transmitted orally-faecally by contaminated drinking water under conditions of poor sanitation . There is no known animal reservoir for these genotypes . HEV genotype 3 can be found in humans and animals in Europe , the US and Asia . For this genotype zoonotic transmission, foodborne or by contact with infected animals has been described . HEV genotype 3 has been identified in pigs , cats , rats and various rodents . Genotype 4 has also been detected in both humans and pigs in Asia and Europe . In immmunocompetent patients the diagnosis of hepatitis E is based on the detection of HEV-specific antibodies . There are different commercial assays available for detection of HEV-specific antibodies . HEV specific IgG antibodies can be detected in patients with previous contact with HEV. They do not differentiate between ongoing HEV infection and past contact with the virus . To prove current infection the detection of HEV RNA by PCR has been established . Numerous assays using different primers have been developed . Furthermore , few quantitative PCR assays have been described. |