Hepatitis E pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Pathogenesis
Transmission
The hepatitis E virus is transmitted mainly through the fecal-oral route, due to fecal contamination of drinking water.
Other transmission routes have been identified, including:
- Foodborne transmission from ingestion of products derived from infected animals
- Transfusion of infected blood products
- Vertical transmission from a pregnant woman to her fetus
- Ingestion of raw or uncooked shellfish has also been identified as the source of sporadic cases in endemic areas.
Although humans are considered the natural host for the hepatitis E virus, antibodies to the hepatitis E virus or closely related viruses have been detected in primates and several other animal species, suggesting infection by the virus.
Hepatitis E is a waterborne disease. Contaminated water or food supplies have been implicated in major outbreaks.
Gross Pathology
Microscopic Pathology
Patients who develop chronic liver disease often have changes in liver histology. These may include:
- Portal hepatitis
- Lymphocytic infiltrate
- Necrosis
In severe cases, these changes may evolve to fibrosis and cirrhosis.[1]
References
- ↑ Halac U, Béland K, Lapierre P, Patey N, Ward P, Brassard J; et al. (2012). "Chronic hepatitis E infection in children with liver transplantation". Gut. 61 (4): 597–603. doi:10.1136/gutjnl-2011-300708. PMID 22115826.