Semin Liver Dis 2013; 33(01): 015-029
DOI: 10.1055/s-0033-1338111
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Epidemiology of Hepatitis E in Low- and Middle-Income Countries of Asia and Africa

Brittany Kmush
1   Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
,
Thomas Wierzba
2   Translational Research Division, International Vaccine Institute, Seoul, Korea
,
Lisa Krain
3   Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
,
Kenrad Nelson
1   Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
3   Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
,
Alain B. Labrique
1   Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
3   Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
› Author Affiliations
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Publication History

Publication Date:
05 April 2013 (online)

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Abstract

Hepatitis E is an acute, viral hepatitis primarily transmitted through the fecal–oral route. The first major epidemic of hepatitis E virus (HEV) was reported in 1955 in Delhi, India. Since that time, numerous epidemics have been reported across the low- and middle-income countries in Asia and Africa. Even in the absence of large-scale outbreaks, hepatitis E is an important cause of clinical hepatitis. Serologic studies across Asia and Africa show a high prevalence of anti-HEV antibodies. Interest in hepatitis E has increased over the last two decades. However, there are many unanswered questions about the epidemiology of hepatitis E, including a low clinical illness rate in children and the high case fatality rate in pregnant women. Widespread usage of a hepatitis E vaccine may serve to relieve the burden of HEV disease in low- and middle-income countries in Africa and Asia.