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Hepatitis E Virus Infection in Children

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Viral Hepatitis in Children

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Abstract

Hepatitis E virus (HEV) infection is a leading cause of acute viral hepatitis worldwide. Approximately 20 million people are infected with HEV annually, resulting in more than three million annual cases of acute HEV and ~70,000 associated deaths (World Health Organization. Hepatitis E (Factsheet No. 280). World Health Organization, 2014; World Health Organization. Prevention and control of viral hepatitis: a framework for global action. World Health Organization. www.who.int/topics/hepatitis, 2012). Although HEV infection among children is often asymptomatic, infection can also lead to a range of symptoms from mild hepatitis to fulminant liver failure and to extrahepatic disease such as pancreatitis, Guillain-Barre syndrome, or Henoch-Schonlein purpura (Verghese VP, Robinson JL. Clin Infect Dis 59(5):689–697, 2014). Among tropical and subtropical climates, HEV is a leading cause of waterborne epidemic viral hepatitis and a major cause of morbidity in developing settings (Gerbi GB et al. Am J Trop Med Hyg 92(2):411–414, 2015; Tsega E et al. Clin Infect Dis 14(4):961–965, 1992). Pregnant women and individuals with underlying liver disease are at highest risk for morbidity and mortality, with few treatment options currently available at this time (Navaneethan U, Al Mohajer M, Shata MT. Liver Int 28(9):1190–1199, 2008). Among children, the risk of HEV infection increases with age, with serologic studies demonstrating peak incidence in early adulthood.

While the overall significance of HEV infection on the majority of immunocompetent children remains unclear, the risk of zoonotically acquired acute and chronic HEV infection among immunocompromised individuals, particularly solid organ transplant (SOT) recipients, has become increasingly apparent (Dalton HR et al. Eur J Gastroenterol Hepatol 20(8):784–790, 2008; Kamar N et al (2008) Hepatitis E virus and chronic hepatitis in organ-transplant recipients. N Engl J Med 358(8):811–817; Kamar N et al. Am J Transplant 8(8):1744–1748, 2008; Halac U et al. Gut 61(4):597–603, 2012; Purcell RH, Emerson SU. J Infect Dis 202(6):819–821, 2010). This chapter will highlight the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment approaches to HEV infection among children and those in high-risk groups, such as pregnant women, SOT recipients, and other immunocompromised hosts (Mushahwar IK. J Med Virol 80(4):646–658, 2008; Mizuo H et al. J Med Virol 76(3):341–349, 2005; Takahashi M, Okamoto H. Hepatol Res 44(1):43–58, 2014; 15. Okamoto H. Virus Res 127(2):216–228, 2007; 16. Mjahed K et al. Arch Gynecol Obstet 274(6):349–353, 2006).

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References

  1. Hyams KC (2002) New perspectives on hepatitis E. Curr Gastroenterol Rep 4(4):302–307

    Article  PubMed  Google Scholar 

  2. Mushahwar IK (2008) Hepatitis E virus: molecular virology, clinical features, diagnosis, transmission, epidemiology, and prevention. J Med Virol 80(4):646–658

    Article  PubMed  Google Scholar 

  3. Takahashi M, Okamoto H (2014) Features of hepatitis E virus infection in humans and animals in Japan. Hepatol Res 44(1):43–58

    Article  PubMed  Google Scholar 

  4. Dalton HR et al (2008) Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis 8(11):698–709

    Article  PubMed  Google Scholar 

  5. Mirazo S et al (2014) Indigenous hepatitis E virus genotype 1 infection, Uruguay. Emerg Infect Dis 20(1):171–173

    Article  PubMed  PubMed Central  Google Scholar 

  6. Buisson Y et al (2000) Identification of a novel hepatitis E virus in Nigeria. J Gen Virol 81.(Pt 4:903–909

    Article  CAS  PubMed  Google Scholar 

  7. van Cuyck-Gandre H et al (1997) Characterization of hepatitis E virus (HEV) from Algeria and Chad by partial genome sequence. J Med Virol 53(4):340–347

    Article  PubMed  Google Scholar 

  8. Tam AW et al (1991) Hepatitis E virus (HEV): molecular cloning and sequencing of the full-length viral genome. Virology 185(1):120–131

    Article  CAS  PubMed  Google Scholar 

  9. Dalton HR et al (2008) Autochthonous hepatitis E in Southwest England: natural history, complications and seasonal variation, and hepatitis E virus IgG seroprevalence in blood donors, the elderly and patients with chronic liver disease. Eur J Gastroenterol Hepatol 20(8):784–790

    Article  CAS  PubMed  Google Scholar 

  10. Banks M et al (2004) Evidence for the presence of hepatitis E virus in pigs in the United Kingdom. Vet Rec 154(8):223–227

    Article  CAS  PubMed  Google Scholar 

  11. World Health Organization (2014) Hepatitis E (Factsheet No. 280). World Health Organization

    Google Scholar 

  12. Mizuo H et al (2005) Possible risk factors for the transmission of hepatitis E virus and for the severe form of hepatitis E acquired locally in Hokkaido, Japan. J Med Virol 76(3):341–349

    Article  CAS  PubMed  Google Scholar 

  13. Okamoto H (2007) Genetic variability and evolution of hepatitis E virus. Virus Res 127(2):216–228

    Article  CAS  PubMed  Google Scholar 

  14. Williams TP et al (2001) Evidence of extrahepatic sites of replication of the hepatitis E virus in a swine model. J Clin Microbiol 39(9):3040–3046

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Tsarev SA et al (1994) Successful passive and active immunization of cynomolgus monkeys against hepatitis E. Proc Natl Acad Sci U S A 91(21):10198–10202

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Clayson ET et al (1995) Viremia, fecal shedding, and IgM and IgG responses in patients with hepatitis E. J Infect Dis 172(4):927–933

    Article  CAS  PubMed  Google Scholar 

  17. Kumar RM et al (2001) Sero-prevalence and mother- to-infant transmission of hepatitis E virus among pregnant women in the United Arab Emirates. Eur J Obstet Gynecol Reprod Biol 100(1):9–15

    Article  CAS  PubMed  Google Scholar 

  18. Navaneethan U, Al Mohajer M, Shata MT (2008) Hepatitis E and pregnancy: understanding the pathogenesis. Liver Int 28(9):1190–1199

    Article  PubMed  PubMed Central  Google Scholar 

  19. Emerson SU, Purcell RH (2001) Recombinant vaccines for hepatitis E. Trends Mol Med 7(10):462–466

    Article  CAS  PubMed  Google Scholar 

  20. Tang X et al (2011) Structural basis for the neutralization and genotype specificity of hepatitis E virus. Proc Natl Acad Sci U S A 108(25):10266–10271

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Jeblaoui A et al (2013) Genotype 4 hepatitis e virus in France: an autochthonous infection with a more severe presentation. Clin Infect Dis 57(4):e122–e126

    Article  PubMed  Google Scholar 

  22. Saravanabalaji S et al (2009) Viral load, antibody titers and recombinant open reading frame 2 protein- induced TH1/TH2 cytokines and cellular immune responses in self-limiting and fulminant hepatitis e. Intervirology 52(2):78–85

    Article  CAS  PubMed  Google Scholar 

  23. Srivastava R et al (2011) Adaptive immune responses during acute uncomplicated and fulminant hepatitis E. J Gastroenterol Hepatol 26(2):306–311

    Article  CAS  PubMed  Google Scholar 

  24. Nguyen HT et al (2012) A naturally occurring human/hepatitis E recombinant virus predominates in serum but not in faeces of a chronic hepatitis E patient and has a growth advantage in cell culture. J Gen Virol 93.(Pt 3:526–530

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Mishra N, Walimbe AM, Arankalle VA (2013) Hepatitis E virus from India exhibits significant amino acid mutations in fulminant hepatic failure patients. Virus Genes 46(1):47–53

    Article  CAS  PubMed  Google Scholar 

  26. Krawczynski K (1993) Hepatitis E. Hepatology 17(5):932–941

    Article  CAS  PubMed  Google Scholar 

  27. Peron JM et al (2007) Fulminant liver failure from acute autochthonous hepatitis E in France: description of seven patients with acute hepatitis E and encephalopathy. J Viral Hepat 14(5):298–303

    Article  CAS  PubMed  Google Scholar 

  28. Nagasaki F et al (2005) A case of acute hepatitis with positive autoantibodies who actually had hepatitis E virus infection. Hepatol Res 32(2):134–137

    Article  PubMed  Google Scholar 

  29. Sylvan SP et al (1995) Hepatitis E in patients with chronic autoimmune liver disease. JAMA 273(5):377–378

    Article  CAS  PubMed  Google Scholar 

  30. Wendum D et al (2005) Acute hepatitis E: a cause of lymphocytic destructive cholangitis. Hum Pathol 36(4):436–438

    Article  PubMed  Google Scholar 

  31. Khuroo MS (1980) Study of an epidemic of non-a, non-B hepatitis. Possibility of another human hepatitis virus distinct from post-transfusion non-a, non-B type. Am J Med 68(6):818–824

    Article  CAS  PubMed  Google Scholar 

  32. World Health Organization (2012) Prevention and control of viral hepatitis: a framework for global action. World Health Organization. www.who.int/topics/hepatitis

  33. Jacobsen KH, Wiersma ST (2010) Hepatitis a virus seroprevalence by age and world region, 1990 and 2005. Vaccine 28(41):6653–6657

    Article  PubMed  Google Scholar 

  34. World Health Organization (2010) The global prevalence of hepatitis E virus infection and susceptibility: a systematic review. www.who/int/ vaccines-documents/

  35. Franco E et al (2012) Hepatitis a: epidemiology and prevention in developing countries. World J Hepatol 4(3):68–73

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kumar A et al (2004) Hepatitis E in pregnancy. Int J Gynaecol Obstet 85(3):240–244

    Article  CAS  PubMed  Google Scholar 

  37. Favorov MO et al (1992) Serologic identification of hepatitis E virus infections in epidemic and endemic settings. J Med Virol 36(4):246–250

    Article  CAS  PubMed  Google Scholar 

  38. Khuroo MS, Khuroo MS, Khuroo NS (2016) Transmission of hepatitis E virus in developing countries. Viruses 8(9):E253

    Article  PubMed Central  CAS  Google Scholar 

  39. Kumar S et al (2013) Hepatitis E virus: the current scenario. Int J Infect Dis 17(4):e228–e233

    Article  PubMed  Google Scholar 

  40. Tsega E et al (1992) Acute sporadic viral hepatitis in Ethiopia: causes, risk factors, and effects on pregnancy. Clin Infect Dis 14(4):961–965

    Article  CAS  PubMed  Google Scholar 

  41. Kane MA et al (1984) Epidemic non-a, non-B hepatitis in Nepal. Recovery of a possible etiologic agent and transmission studies in marmosets. JAMA 252(22):3140–3145

    Article  CAS  PubMed  Google Scholar 

  42. Khuroo MS et al (1983) Acute sporadic non-a, non-B hepatitis in India. Am J Epidemiol 118(3):360–364

    Article  CAS  PubMed  Google Scholar 

  43. Patra S et al (2007) Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med 147(1):28–33

    Article  PubMed  Google Scholar 

  44. Strand RT et al (2003) Infectious a etiology of jaundice among pregnant women in Angola. Scand J Infect Dis 35(6–7):401–403

    Article  PubMed  Google Scholar 

  45. Stoszek SK et al (2006) Hepatitis E antibody seroconversion without disease in highly endemic rural Egyptian communities. Trans R Soc Trop Med Hyg 100(2):89–94

    Article  PubMed  Google Scholar 

  46. Echevarria JM et al (2013) Hepatitis E virus infection in Latin America: a review. J Med Virol 85(6):1037–1045

    Article  CAS  PubMed  Google Scholar 

  47. Lopes Dos Santos DR et al (2010) First report of a human autochthonous hepatitis E virus infection in Brazil. J Clin Virol 47(3):276–279

    Article  PubMed  Google Scholar 

  48. Tsang TH et al (2000) Acute hepatitis E infection acquired in California. Clin Infect Dis 30(3):618–619

    Article  CAS  PubMed  Google Scholar 

  49. Mansuy JM et al (2004) Hepatitis E in the south west of France in individuals who have never visited an endemic area. J Med Virol 74(3):419–424

    Article  PubMed  Google Scholar 

  50. Dalton HR et al (2007) Locally acquired hepatitis E in chronic liver disease. Lancet 369(9569):1260

    Article  CAS  PubMed  Google Scholar 

  51. Hoofnagle JH, Nelson KE, Purcell RH (2012) Hepatitis E. N Engl J Med 367(13):1237–1244

    Article  CAS  PubMed  Google Scholar 

  52. Kamar N et al (2012) Hepatitis E. Lancet 379(9835):2477–2488

    Article  PubMed  Google Scholar 

  53. Tei S et al (2003) Zoonotic transmission of hepatitis E virus from deer to human beings. Lancet 362(9381):371–373

    Article  PubMed  Google Scholar 

  54. Meng XJ (2010) Hepatitis E virus: animal reservoirs and zoonotic risk. Vet Microbiol 140(3–4):256–265

    Article  CAS  PubMed  Google Scholar 

  55. Christou L, Kosmidou M (2013) Hepatitis E virus in the Western world–a pork-related zoonosis. Clin Microbiol Infect 19(7):600–604

    Article  CAS  PubMed  Google Scholar 

  56. Barnaud E et al (2012) Thermal inactivation of infectious hepatitis E virus in experimentally contaminated food. Appl Environ Microbiol 78(15):5153–5159

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Cossaboom CM et al (2016) Risk factors and sources of foodborne hepatitis E virus infection in the United States. J Med Virol 88(9):1641–1645

    Article  PubMed  Google Scholar 

  58. Colson P et al (2010) Pig liver sausage as a source of hepatitis E virus transmission to humans. J Infect Dis 202(6):825–834

    Article  PubMed  Google Scholar 

  59. Verghese VP, Robinson JL (2014) A systematic review of hepatitis E virus infection in children. Clin Infect Dis 59(5):689–697

    Article  PubMed  Google Scholar 

  60. Kuniholm MH et al (2009) Epidemiology of hepatitis E virus in the United States: results from the third National Health and nutrition examination survey, 1988–1994. J Infect Dis 200(1):48–56

    Article  PubMed  Google Scholar 

  61. Teshale EH et al (2015) Decline in hepatitis E virus antibody prevalence in the United States from 1988– 1994 to 2009–2010. J Infect Dis 211(3):366–373

    Article  CAS  PubMed  Google Scholar 

  62. Faber MS et al (2012) Hepatitis E virus seroprevalence among adults, Germany. Emerg Infect Dis 18(10):1654–1657

    Article  PubMed  PubMed Central  Google Scholar 

  63. Fischler B et al (2016) Hepatitis E in children: a position paper by the ESPGHAN hepatology committee. J Pediatr Gastroenterol Nutr 63(2):288–294

    Article  CAS  PubMed  Google Scholar 

  64. Meng QF et al (2015) Seroprevalence and risk factors of hepatitis E virus infection among children in China. J Med Virol 87(9):1573–1577

    Article  CAS  PubMed  Google Scholar 

  65. Liu P et al (2012) Phylogenetic analysis of 626 hepatitis E virus (HEV) isolates from humans and animals in China (1986–2011) showing genotype diversity and zoonotic transmission. Infect Genet Evol 12(2):428–434

    Article  CAS  PubMed  Google Scholar 

  66. Bendall R et al (2010) A comparison of two commercially available anti-HEV IgG kits and a re-evaluation of anti-HEV IgG seroprevalence data in developed countries. J Med Virol 82(5):799–805

    Article  CAS  PubMed  Google Scholar 

  67. Krumbholz A et al (2014) Prevalence of hepatitis E virus antibodies in children in Germany. Pediatr Infect Dis J 33(3):258–262

    Article  PubMed  Google Scholar 

  68. Robson SC et al (1992) Hospital outbreak of hepatitis E. Lancet 339(8806):1424–1425

    Article  CAS  PubMed  Google Scholar 

  69. Psichogiou M et al (1996) Hepatitis E virus (HEV) infection in haemodialysis patients. The multicentre Haemodialysis cohort study on viral hepatitis. Nephrol Dial Transplant 11(6):1093–1095

    Article  CAS  PubMed  Google Scholar 

  70. Hewitt PE et al (2014) Hepatitis E virus in blood components: a prevalence and transmission study in Southeast England. Lancet 384(9956):1766–1773

    Article  PubMed  Google Scholar 

  71. Colson P et al (2007) Transfusion-associated hepatitis E, France. Emerg Infect Dis 13(4):648–649

    Article  PubMed  PubMed Central  Google Scholar 

  72. Halac U et al (2012) Chronic hepatitis E infection in children with liver transplantation. Gut 61(4):597–603

    Article  CAS  PubMed  Google Scholar 

  73. Hoerning A et al (2012) Prevalence of hepatitis E virus infection in pediatric solid organ transplant recipients–a single-center experience. Pediatr Transplant 16(7):742–747

    Article  PubMed  Google Scholar 

  74. Kamar N et al (2014) Hepatitis E virus infection. Clin Microbiol Rev 27(1):116–138

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  75. Mast EE, Purdy MA, Krawczynski K (1996) Hepatitis E. Baillieres Clin Gastroenterol 10(2):227–242

    Article  CAS  PubMed  Google Scholar 

  76. Fiore S, Savasi V (2009) Treatment of viral hepatitis in pregnancy. Expert Opin Pharmacother 10(17):2801–2809

    Article  PubMed  Google Scholar 

  77. Khuroo MS, Kamili S (2003) Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy. J Viral Hepat 10(1):61–69

    Article  CAS  PubMed  Google Scholar 

  78. Khuroo MS et al (1981) Incidence and severity of viral hepatitis in pregnancy. Am J Med 70(2):252–255

    Article  CAS  PubMed  Google Scholar 

  79. Arora NK et al (1996) Acute viral hepatitis types E, a, and B singly and in combination in acute liver failure in children in North India. J Med Virol 48(3):215–221

    Article  CAS  PubMed  Google Scholar 

  80. Jagadisan B et al (2012) Acute on chronic liver disease in children from the developing world: recognition and prognosis. J Pediatr Gastroenterol Nutr 54(1):77–82

    Article  PubMed  Google Scholar 

  81. Crossan CL et al (2014) Hepatitis E virus in patients with acute severe liver injury. World J Hepatol 6(6):426–434

    Article  PubMed  PubMed Central  Google Scholar 

  82. Manka P et al (2015) Hepatitis E virus infection as a possible cause of acute liver failure in Europe. Clin Gastroenterol Hepatol 13(10):1836–1842 e2; quiz e157–8

    Article  PubMed  Google Scholar 

  83. Lau JY et al (1995) Detection of hepatitis E virus genome and gene products in two patients with fulminant hepatitis E. J Hepatol 22(6):605–610

    Article  CAS  PubMed  Google Scholar 

  84. Munne MS et al (2006) Molecular characterization of hepatitis E virus in three acute liver failure cases in children in Argentina. Acta Gastroenterol Latinoam 36(3):125–130

    PubMed  Google Scholar 

  85. Goto K et al (2006) Prevalence of hepatitis E virus infection in Japanese children. J Pediatr Gastroenterol Nutr 42(1):89–92

    Article  PubMed  Google Scholar 

  86. Arends JE et al (2014) Hepatitis E: an emerging infection in high income countries. J Clin Virol 59(2):81–88

    Article  CAS  PubMed  Google Scholar 

  87. Haagsma EB et al (2008) Chronic hepatitis E virus infection in liver transplant recipients. Liver Transpl 14(4):547–553

    Article  PubMed  Google Scholar 

  88. Kamar N et al (2011) Factors associated with chronic hepatitis in patients with hepatitis E virus infection who have received solid organ transplants. Gastroenterology 140(5):1481–1489

    Article  PubMed  Google Scholar 

  89. Gerolami R et al (2011) Treatment of severe acute hepatitis E by ribavirin. J Clin Virol 52(1):60–62

    Article  CAS  PubMed  Google Scholar 

  90. Bouts AH, Schriemer PJ, Zaaijer HL (2015) Chronic hepatitis E resolved by reduced immunosuppression in pediatric kidney transplant patients. Pediatrics 135(4):e1075–e1078

    Article  PubMed  Google Scholar 

  91. Bazerbachi F et al (2016) Extra-hepatic manifestations associated with hepatitis E virus infection: a comprehensive review of the literature. Gastroenterol Rep (Oxf) 4(1):1–15

    Article  Google Scholar 

  92. Kamar N et al (2011) Hepatitis E virus and neurologic disorders. Emerg Infect Dis 17(2):173–179

    Article  PubMed  PubMed Central  Google Scholar 

  93. Kamar N et al (2012) Hepatitis E virus and the kidney in solid-organ transplant patients. Transplantation 93(6):617–623

    PubMed  Google Scholar 

  94. Motte A et al (2012) Hepatitis E in three immunocompromized children in southeastern France. J Clin Virol 53(2):162–166

    Article  PubMed  Google Scholar 

  95. Aggarwal R (2013) Diagnosis of hepatitis E. Nat Rev Gastroenterol Hepatol 10(1):24–33

    Article  CAS  PubMed  Google Scholar 

  96. Gupta P et al (2012) Immunohistochemistry for the diagnosis of hepatitis E virus infection. J Viral Hepat 19(2):e177–e183

    Article  CAS  PubMed  Google Scholar 

  97. Mirazo S et al (2014) Transmission, diagnosis, and management of hepatitis E: an update. Hepat Med 6:45–59

    Article  PubMed  PubMed Central  Google Scholar 

  98. Lhomme S et al (2016) Hepatitis E pathogenesis. Viruses 8(8):E212

    Article  PubMed  Google Scholar 

  99. Sue PK et al (2015) Variability of hepatitis E serologic assays in a pediatric liver transplant recipient: challenges to diagnosing hepatitis E virus infection in the United States. Transpl Infect Dis 17(2):284–288

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Pas SD et al (2013) Diagnostic performance of selected commercial HEV IgM and IgG ELISAs for immunocompromised and immunocompetent patients. J Clin Virol 58(4):629–634

    Article  CAS  PubMed  Google Scholar 

  101. Aggarwal R et al (2000) Duration of viraemia and faecal viral excretion in acute hepatitis E. Lancet 356(9235):1081–1082

    Article  CAS  PubMed  Google Scholar 

  102. Khuroo MS, Dar MY (1992) Hepatitis E: evidence for person-to-person transmission and inability of low dose immune serum globulin from an Indian source to prevent it. Indian J Gastroenterol 11(3):113–116

    CAS  PubMed  Google Scholar 

  103. Peron JM et al (2011) Acute autochthonous hepatitis E in western patients with underlying chronic liver disease: a role for ribavirin? J Hepatol 54(6):1323–1324 author reply 1324-5

    Article  CAS  PubMed  Google Scholar 

  104. Pischke S et al (2010) Hepatitis E virus infection as a cause of graft hepatitis in liver transplant recipients. Liver Transpl 16(1):74–82

    Article  PubMed  Google Scholar 

  105. Schildgen O, Muller A, Simon A (2008) Chronic hepatitis E and organ transplants. N Engl J Med 358(23):2521–2522. author reply 2522

    Article  CAS  PubMed  Google Scholar 

  106. Parvez MK (2013) Chronic hepatitis E infection: risks and controls. Intervirology 56(4):213–216

    Article  CAS  PubMed  Google Scholar 

  107. Saab S et al (2004) Outcomes of acute rejection after interferon therapy in liver transplant recipients. Liver Transpl 10(7):859–867

    Article  PubMed  Google Scholar 

  108. Kamar N et al (2014) Ribavirin for chronic hepatitis E virus infection in transplant recipients. N Engl J Med 370(12):1111–1120

    Article  CAS  PubMed  Google Scholar 

  109. Mjahed K et al (2006) Acute fatty liver of pregnancy. Arch Gynecol Obstet 274(6):349–353

    Article  PubMed  Google Scholar 

  110. Chibber RM, Usmani MA, Al-Sibai MH (2004) Should HEV infected mothers breast feed? Arch Gynecol Obstet 270(1):15–20

    Article  PubMed  Google Scholar 

  111. Shrestha MP et al (2007) Safety and efficacy of a recombinant hepatitis E vaccine. N Engl J Med 356(9):895–903

    Article  CAS  PubMed  Google Scholar 

  112. Zhu FC et al (2010) Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large- scale, randomised, double-blind placebo-controlled, phase 3 trial. Lancet 376(9744):895–902

    Article  CAS  PubMed  Google Scholar 

  113. Zhang J et al (2015) Long-term efficacy of a hepatitis E vaccine. N Engl J Med 372(10):914–922

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Paul K. Sue

  2. Johns Hopkins University School of medicine, Baltimore, MD, USA

    Wikrom Karnsakul

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  1. Department of Pediatrics, National Taiwan University College of Medicine, Taipei, Taiwan

    Mei-Hwei Chang

  2. Department of Pediatrics, Johns Hopkins University School of Mediine, Baltimore, MD, USA

    Kathleen B. Schwarz

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Sue, P.K., Karnsakul, W. (2019). Hepatitis E Virus Infection in Children. In: Chang, MH., Schwarz, K. (eds) Viral Hepatitis in Children. Springer, Singapore. https://doi.org/10.1007/978-981-13-0050-9_14

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