[Hepatitis E virus infection: a paradigm shift?].

Hepatitis E is an infectious disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly a self-limiting travel-associated disease without chronic evolution. In recent years an increasing number of authochtonous HEV-infections has been described in industrialized countries. HEV-infections frequently take a mild clinical silent course of disease in immunocompetent individuals and thus HEV infection is largely underdiagnosed. Therefore, the anti-HEV-prevalence is much higher than anticipated with 2 - 20% in Western Europe. HEV genotype 3 infections must be considered as zoonotic infections with several animals including swines serving as reservoirs. Cases of HEV-transmissions by blood transfusion were described not only in Asia but also in France and the UK. HEV-infections may take severe courses in pregnant women and patients with chronic liver diseases, sometimes leading to acute liver failure. In addition several centres described cases of progressive chronic HEV-infection in organ transplant recipients and HIV-positive patients during the last two years. In this review we summarize the current state-of-the-art on the knowledge of HEV-infections in industrialised countries. Georg Thieme Verlag KG Stuttgart, New York.