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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Hepatitis E virus: An ancient hidden enemy in Latin America
Nora A Fierro, Mauricio Realpe, Tzintli Meraz-Medina, Sonia Roman, Arturo Panduro
Nora A Fierro, Immunovirology Unit, Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, “Fray Antonio Alcalde”, Department of Physiology, Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México
Mauricio Realpe, Departamento de Medicina Veterinaria, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Nextipac, Zapopan 44600, Jalisco, México
Tzintli Meraz-Medina, Universidad Politécnica de la Zona Metropolitana de Guadalajara, Tlajomulco de Zúñiga 45640, Jalisco, Mexico
Sonia Roman, Arturo Panduro, Department of Molecular Biology in Medicine, Civil Hospital de Guadalajara “Fray Antonio Alcalde”, and Health Sciences Center, University of Guadalajara, Guadalajara 44280, Jalisco, México
Author contributions: Fierro NA and Realpe M contributed equally to this work, they performed the research and wrote the paper; Meraz-Medina T, Roman S and Panduro A performed the research and critically revised the manuscript.
Supported by Consejo Nacional de Ciencia y Tecnologia of Mexico (CONACYT) Grant No.127229 and Grant No.188240 to Fierro NA.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Arturo Panduro, MD, PhD, FAASLD, Department of Molecular Biology in Medicine, Civil Hospital de Guadalajara “Fray Antonio Alcalde”, and Health Sciences Center, University of Guadalajara, Hospital # 278, Col. El Retiro, Guadalajara 44280, Jalisco, México. apanduro@prodigy.net.mx
Telephone: +52-33-36147743 Fax: +52-33-36147743
Received: July 21, 2015
Peer-review started: July 30, 2015
First decision: September 29, 2015
Revised: October 21, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: February 21, 2016
Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide. HEV is an RNA-containing virus and the only member of the genus Hepevirus in the family Hepeviridae. Human HEV is classified into four genotypes widely distributed across the world. The virus is mainly transmitted via the fecal-oral route, and water-borne epidemics have become characteristic of hepatitis E in developing countries, including those in Latin America. The zoonotic potential of HEV is broadly recognized. Thus, there is an urgent need to re-evaluate virus transmission scenarios and to enforce epidemiological surveillance systems. Additionally, it is known that HEV infections, initially defined as self-limiting, can also take chronic courses in immunocompromised patients. Moreover, we recently reported a high seroprevalence of HEV in samples from cirrhotic patients with no other etiological agents present, suggesting the potential role of HEV in the development of chronic liver illness. In this review, HEV genomic variability, transmission, chronic infectious course, zoonotic potential and treatment are discussed. Focus is placed on the impact of HEV infection in Latin America, to support the development of specific control strategies and the handling of this important and typically imperceptible viral infection.
Core tip: Despite the widespread presence of hepatitis E virus (HEV), this pathogen is not commonly considered from a global public health perspective. Active research on hepatitis E both in animals and humans has provided novel insight into HEV pathogenesis, zoonotic potential and its role in chronic liver disease. Detailed guidelines for tracking cases need to be developed to contain the virus. This action is particularly necessary in endemic and emerging situations in regions with a higher risk of developing the infection, including Latin America.
