Last reviewed: 5 Oct 2024
Last updated: 13 Mar 2024
Summary
Definition
History and exam
Key diagnostic factors
- jaundice/scleral icterus
- asterixis
Full details
Other diagnostic factors
- asymptomatic
- malaise
- fatigue
- right upper quadrant tenderness
- fever
- anorexia
- nausea/vomiting
- arthralgia/arthritis
- abdominal pain
- diarrhea
- neurologic manifestations
- signs of coagulopathy
Full details
Risk factors
- born or living in or travel to geographic regions where HEV is endemic
- immunosuppression
- infected mother (for fetus)
- person-to-person transmission
- occupational exposure
- blood/blood products transfusion
- organ transplantation (if organ donor is HEV-positive)
Full details
Diagnostic tests
1st tests to order
- serum antibody to HEV
- HEV RNA nucleic acid amplification techniques (NAATs)
- serologic tests for other causes of viral hepatitis
- liver biochemistries
- CBC
- basic metabolic panel
- coagulation profile
Full details
Tests to consider
- abdominal ultrasound
- CT/MRI
- liver biopsy
Full details
Treatment algorithm
ACUTE
acute HEV infection
ONGOING
chronic HEV infection: nonpregnant
chronic HEV infection: pregnant
Contributors
Authors
Jawad Ahmad, MD, FRCP, FAASLD
Professor of Medicine
Division of Liver Diseases
Mount Sinai Hospital
New York
NY
Disclosures
JA declares that he has no competing interests.
Peer reviewers
Scott J. Cotler, MD
Professor of Medicine
Director, Division of Hepatology
Loyola University Medical Center
Maywood
IL
Disclosures
SJC declares that he has no competing interests.
David John Mutimer, MBBS, MD
Professor of Clinical Hepatology
University of Birmingham
Birmingham
UK
Disclosures
DJM declares that he has no competing interests.
Differentials
- Acute viral hepatitis A
- Acute viral hepatitis B
- Acute viral hepatitis C
More DifferentialsGuidelines
- Viral hepatitis: hepatitis E
- Clinical practice guidelines on hepatitis E virus infection
More Guidelines- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer