Introduction

It is one of the viruses that cause inflammation of the liver. It is very common in our part of the world. The scarcity of clean drinking water and poor sanitation increase the chances of contracting hepatitis E. like hepatitis A, usually, it does not cause a long-lasting disease (scarring of the Liver) but can be dangerous in pregnant patients and in those who already have chronic liver disease due to any other reason. Rarely, it can cause life threatening severe liver disease with features of liver failure, requiring intensive management and liver transplant. In our society, some cultural myths are associated with this disease i.e, herbal tonics, amulets etc, which are of no benefit. Avoid going to quacks.

Transmission

Hepatitis E virus is usually transmitted from use of contaminated water, poor hand washing or poorly cooked meat. Consumption of Shellfish is also a risk factor.

Symptoms

It usually presents as:

Fever

Jaundice (yellowish discoloration of the skin and white of the eyes)

Nausea and vomiting

Right side upper abdominal pain

Others symptoms may include

Dark urine and light-coloured stools

Sometimes nonspecific symptoms such as joint pain, tiredness and lethargy

The duration of symptoms is variable but can be prolonged in some cases which again does not mean that a specific drug therapy is needed.

Diagnosis

A specific set of blood test is required initially for the diagnosis as recommended by your doctor.

Diagnosis can be made by testing the antibody in the blood against hepatitis E. Liver function tests and PT INR are some of the other important investigations required.

Treatment

There is no medication to treat hepatitis E. Treatment is supportive in most cases such as good hydration and managing the symptoms as the disease is usually self-limiting. It should be kept in mind that drugs are an important cause of liver injury so unnecessary medications should be avoided as they can further damage the liver. Pregnant women with hepatitis E should contact their doctor immediately as they may require very close monitoring and follow-up.

Most patients recover fully without any sequel. The subset of patients with severe liver disease along with the complications such as altered level of consciousness, require inpatient management and may end up undergoing liver transplant.

Prevention

Boiled water and proper hygiene are two important aspects for prevention of the transmission of the virus.