Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review

Acute-on-chronic liver failure (ACLF) and acute liver failure (ALF) are severe hepatitis that occur in patients with and without chronic liver diseases and/or cirrhosis, respectively, and both often result in death. Hepatitis A virus (HAV) and hepatitis E virus (HEV) infection can cause these severe...

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Main Authors: Reina Sasaki-Tanaka, Tatsuo Kanda, Takeshi Yokoo, Hiroyuki Abe, Kazunao Hayashi, Akira Sakamaki, Hiroteru Kamimura, Shuji Terai
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/14/5/454
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author Reina Sasaki-Tanaka
Tatsuo Kanda
Takeshi Yokoo
Hiroyuki Abe
Kazunao Hayashi
Akira Sakamaki
Hiroteru Kamimura
Shuji Terai
author_facet Reina Sasaki-Tanaka
Tatsuo Kanda
Takeshi Yokoo
Hiroyuki Abe
Kazunao Hayashi
Akira Sakamaki
Hiroteru Kamimura
Shuji Terai
author_sort Reina Sasaki-Tanaka
collection DOAJ
description Acute-on-chronic liver failure (ACLF) and acute liver failure (ALF) are severe hepatitis that occur in patients with and without chronic liver diseases and/or cirrhosis, respectively, and both often result in death. Hepatitis A virus (HAV) and hepatitis E virus (HEV) infection can cause these severe conditions. We reviewed the role of HAV and HEV, which infect humans through the fecal–oral route, in ALF and ACLF in Asian countries. This narrative review was the derived from a traditional non-systematic review. Hepatitis A should be recognized as one of the sexually transmitted infections, especially among men who have sex with men. HAV genotype IIIA infection seems to present a more severe clinical manifestation. Acute HEV-1 infection is associated with ALF in pregnant women in India. HEV-4, rather than HEV-3, was found in severe hepatitis in Japan. HEV also plays a role as a cause of acute insult and/or chronic liver disease in immunocompromised patients with ACLF. Further studies are needed for the development of vaccines and antivirals against HAV and HEV infections. Despite the limitations of the recording of cases and the extent of specific vaccinations, multidisciplinary cooperation, involving hepatologists, virologists, experts in public health, etc., may improve the treatment of HAV and HEV infection.
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spelling doaj-art-e222deff40d844f08c04dc8621b3bf0d2025-08-20T01:56:44ZengMDPI AGPathogens2076-08172025-05-0114545410.3390/pathogens14050454Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative ReviewReina Sasaki-Tanaka0Tatsuo Kanda1Takeshi Yokoo2Hiroyuki Abe3Kazunao Hayashi4Akira Sakamaki5Hiroteru Kamimura6Shuji Terai7Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanDivision of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8520, JapanAcute-on-chronic liver failure (ACLF) and acute liver failure (ALF) are severe hepatitis that occur in patients with and without chronic liver diseases and/or cirrhosis, respectively, and both often result in death. Hepatitis A virus (HAV) and hepatitis E virus (HEV) infection can cause these severe conditions. We reviewed the role of HAV and HEV, which infect humans through the fecal–oral route, in ALF and ACLF in Asian countries. This narrative review was the derived from a traditional non-systematic review. Hepatitis A should be recognized as one of the sexually transmitted infections, especially among men who have sex with men. HAV genotype IIIA infection seems to present a more severe clinical manifestation. Acute HEV-1 infection is associated with ALF in pregnant women in India. HEV-4, rather than HEV-3, was found in severe hepatitis in Japan. HEV also plays a role as a cause of acute insult and/or chronic liver disease in immunocompromised patients with ACLF. Further studies are needed for the development of vaccines and antivirals against HAV and HEV infections. Despite the limitations of the recording of cases and the extent of specific vaccinations, multidisciplinary cooperation, involving hepatologists, virologists, experts in public health, etc., may improve the treatment of HAV and HEV infection.https://www.mdpi.com/2076-0817/14/5/454Asiagenotypehepatitis A virushepatitis E virusvaccine
spellingShingle Reina Sasaki-Tanaka
Tatsuo Kanda
Takeshi Yokoo
Hiroyuki Abe
Kazunao Hayashi
Akira Sakamaki
Hiroteru Kamimura
Shuji Terai
Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
Pathogens
Asia
genotype
hepatitis A virus
hepatitis E virus
vaccine
title Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
title_full Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
title_fullStr Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
title_full_unstemmed Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
title_short Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
title_sort hepatitis a and e viruses are important agents of acute severe hepatitis in asia a narrative review
topic Asia
genotype
hepatitis A virus
hepatitis E virus
vaccine
url https://www.mdpi.com/2076-0817/14/5/454
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