The Molecular and Clinical Paradigm of Hepatitis E Virus: From Genomic Architecture to Mitigation Strategies

Hepatitis E virus (HEV) is a major etiological agent of acute viral hepatitis globally. Although HEV infection is mostly self-limiting in immunocompetent individuals, immunocompromised individuals particularly pregnant women are at high risk for progression to chronic hepatitis and related complications. The virus comprises eight genotypes from HEV-1 to HEV-8 with distinct host ranges: HEV-1 and HEV-2 are limited to humans; HEV-3, HEV-4, HEV-7 and Rat-HEV are zoonotic; whereas HEV-5, HEV-6, and HEV-8 are limited to animal. In addition to hepatic disease, HEV is recognized for its extrahepatic manifestations, including neurological and renal disorders. Due to continued burden of transmission and the absence of globally implemented vaccination strategy the preventive measures based on improved water quality, hygiene, and targeted immunization remain critical for controlling HEV infection. This review Summarizes current knowledge on HEV genome, epidemiology, pathogenesis, clinical features, diagnosis, prevention, and highlights emerging research priorities as future perspective.