Hepatitis E

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; hepatitis A, hepatitis B, hepatitis C, hepatitis D and hepatitis E. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer.

Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.

Hepatitis E

Hepatitis E is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade normal cells in your body. The hepatitis E virus has different types that spread in different ways.

• Some types are spread by drinking contaminated water. These types are more common in developing countries, including parts of Africa, Asia, Central America, and the Middle East.
• Other types are spread by eating undercooked pork or wild game, such as deer. These types are more common in developed countries, such as the United States, Australia, Japan, and parts of Europe and East Asia.

Hepatitis E typically causes acute, or short-term, infection.

Acute hepatitis E

Acute hepatitis E is a short-term infection. In most cases, people’s bodies are able to recover and fight off the infection and the virus goes away. People usually get better without treatment after several weeks.

Chronic hepatitis E

Chronic hepatitis E is a long-lasting infection that occurs when your body isn’t able to fight off the virus and the virus does not go away. Chronic hepatitis E is rare and only occurs in people with weakened immune systems. For example, hepatitis E may become chronic in people taking medicines that weaken their immune system after an organ transplant, or in people who have HIV or AIDS.

How common is hepatitis E?

Hepatitis E is more common in developing countries, where sanitation is poor and access to clean water is limited.

Although experts used to think hepatitis E was rare in the United States, recent research suggests that about 20 percent of the population has had hepatitis E.

How serious is hepatitis E?

The types of hepatitis E that are common in developing countries are likely to cause severe infections, especially in pregnant women.

The types of hepatitis E that are common in developed countries are often mild and cause no symptoms. Many people don’t know they’ve had these types of hepatitis E.

Who is more likely to get hepatitis E?

Different types of hepatitis E are more likely to affect different groups of people. The types of hepatitis E that are more common in developing countries are more likely to affect adolescents and young adults.²⁶

In contrast, the types of hepatitis E that are more common in developed countries most often affect older men.²⁶

What are the complications of hepatitis E?

Acute hepatitis E complications

Most people recover from acute hepatitis E without complications. In some cases, acute hepatitis E may cause acute liver failure, a condition in which the liver fails suddenly. Acute liver failure due to hepatitis E is more common in

• pregnant women
• people who have other liver diseases

In pregnant women, hepatitis E can cause other complications for the mother and baby, such as stillbirth, premature birth, or low birthweight.

Chronic hepatitis E complications

Chronic hepatitis E—which is rare and only occurs in people with weakened immune systems—may lead to complications such as cirrhosis or liver failure.

What are the symptoms of hepatitis E?

Many people infected with hepatitis E have no symptoms. Some people have symptoms 15 to 60 days after they become infected with the virus.²⁷ These symptoms may include

• feeling tired
• nausea and vomiting
• poor appetite
• pain over the liver, in the upper part of the abdomen
• darkening of the color of urine
• lightening of color of stool
• yellowish tint to the whites of the eyes and skin, called jaundice

People with hepatitis E typically get better without treatment after several weeks.

What causes hepatitis E?

The hepatitis E virus causes hepatitis E. In developing countries, hepatitis E typically spreads through drinking contaminated water. In developed countries, such as the United States, hepatitis E typically spreads from animals to people, when people eat undercooked pork or wild game, such as deer.

Research suggests that hepatitis E can also spread through blood transfusion, but this is very rare.

How do doctors diagnose hepatitis E?

Doctors diagnose hepatitis E based on symptoms and blood tests. A health care professional will take a blood sample from you and send the sample to a lab. Blood tests can detect antibodies to the hepatitis E virus and show whether you have hepatitis E. The virus can also be detected in blood and in stool samples taken during acute hepatitis E infection.

How do doctors treat hepatitis E?

Treatment for acute hepatitis E includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms.

Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicines—any of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis E.

See your doctor regularly to make sure your body has fully recovered.

Doctors may treat chronic hepatitis E with ribavirin or peginterferon alfa-2a (Pegasys).

How can I protect myself from hepatitis E infection?

When traveling in a developing country, drink bottled water. Use bottled water to brush your teeth, make ice cubes, and wash fruits and vegetables.

Also, make sure any pork or deer you eat is thoroughly cooked, both in developing countries and in developed countries such as the United States.

How can I prevent spreading hepatitis E to others?

Research suggests that it is uncommon for people to spread hepatitis E directly to other people. If you have hepatitis E, you can reduce your chance of spreading the infection by washing your hands with warm, soapy water after using the toilet and before preparing food. Talk with a blood donation center before you donate blood.

Is a hepatitis E vaccine available?

No vaccine for hepatitis E is available in the United States. Vaccines have been developed and are used in China.

What should I eat and drink if I have hepatitis E?

If you have hepatitis E, you should eat a balanced, healthy diet. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.