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Epidemiology of Viral Hepatitis A and E: A Global View

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Viral Hepatitis in Children

Abstract

There are many similarities between the two human enterically transmitted hepatitis viruses, hepatitis A virus (HAV) and hepatitis E virus (HEV), in their epidemiology and the diseases they cause. However, important differences exist as well (Table 2.1). Both viruses are small, positive sense, single-stranded RNA viruses that replicate in the liver, causing similar symptoms and resulting in similar histopathology. Both viruses are non-enveloped when discharged from the liver into the biliary tree but also can be secreted into the bloodstream containing capsular material from the hepatocyte as a pseudomembrane. Both of these hepatitis viruses have been responsible for large epidemics and can be acquired from contaminated food. However, subclinical infection with HAV among infants and young children is very common especially in developing countries, but HEV infections typically occur as large waterborne epidemics in adolescents and adults in developing countries. Infants and young children have much lower rates of infection during these epidemics. A characteristic feature of HEV epidemics is a mortality of 1% or less in the general population but a mortality of 20% or higher among pregnant women. Sporadic infections from HEV occur among adults in industrialized countries from foodborne transmission. In contrast, clinically apparent hepatitis from HAV infections in developing countries is rare because of very high rates of subclinical infections among infants and young children resulting in high levels of immunity in the populations. Countries that have experienced the transition from low to higher levels of socioeconomic development have experienced an increasing number of hepatitis cases from HAV due to declining population immunity to the virus. The dynamic epidemiology of these two hepatitis viruses will be described in this chapter.

Table 2.1 Comparative features of hepatitis A and E virus
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Authors and Affiliations

  1. Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    Kenrad E. Nelson

  2. Department of Public Health, Food Studies, and Nutrition, Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA

    Brittany L. Kmush

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  1. Kenrad E. Nelson
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Correspondence to Kenrad E. Nelson .

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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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Nelson, K.E., Kmush, B.L. (2019). Epidemiology of Viral Hepatitis A and E: A Global View. In: Chang, MH., Schwarz, K. (eds) Viral Hepatitis in Children. Springer, Singapore. https://doi.org/10.1007/978-981-13-0050-9_2

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