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Hepatitis  E Infection
Hepatitis E Infection
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Microbiology of hepatitis e virus

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Hepatitis E virus in detail

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Microbiology of hepatitis e virus

  1. 1. VIRION: Non-enveloped, spherical, 32-34 nm in diameter. RNA genome is enclosed within a capsid composed of 60 capsid proteins, assembled into T=1 isometric icosahedral particle. Hepatitis E Virus (Hepeviridae family)
  2. 2. GENOME: Monopartite, linear, ssRNA(+) genome . The 5’ end is capped and the 3’ terminus is polyadenylated. GENE EXPRESSION: ORF1 encodes nonstructural proteins; ORF2 encodes capsid protein; ORF3 encodes small immunogenic protein.
  3. 3. By Oral,Fecal route. Zoonotic & Fomite. Host : Human, pig, monkey, some rodents,& chicken.
  4. 4. INFECTION : Primary site : possibly the intestinal tract. Secondary site : hepatocytes & possibly cells in biliary tract.
  5. 5. Treatment options for chronic hepatitis include:  The first step in the treatment is reduction of immuno supression medication in 16 solid organ transplant recipients with chronic hepatitis E ,led to clearance of HEV in 4 cases (25%) .  A second possible treatment option is administration of pegylated -interferon α with ribavirin.  Treatment durations varied between 3 and 12 months.  Ribavirin has also been used in a not -transplanted patient with severe acute hepatitis E who showed rapid improvement of symptoms and liver function tests during treatment .
  6. 6. No commercial HEV vaccine is currently available. A vaccine developed by GSK & the Walter Reed Army Institute that was successfully tested in a Phase II study (Shrestha 2007). However, this vaccine has not been further developed.
  7. 7. A group from China reported data recently from a very large successful Phase III vaccine trial (Zhu 2010) . This trial included almost 110,000 individuals who received either a recombinant HEV vaccine (“HEV 239”) or placebo. The vaccine efficacy after 3 doses was 100%. Moreover, the efficacy of this vaccine needs to be evaluated in special risks groups such as patients with end-stage liver disease or immuno suppressed individuals. It is also unknown if HEV -239 also protects from HEV genotype 3 infection (Wedemeyer and Pischke 2011)

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