Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review
Abstract
:1. Introduction
2. Acute Liver Failure (ALF) and Acute-on-Chronic Liver Failure (ACLF)
3. Hepatitis A Virus (HAV)
3.1. Diagnosis of Hepatitis A
3.2. Symptoms of HAV Infection
3.3. HAV Genotypes and Clinical Manifestations
3.4. Acute Severe Hepatitis A
3.5. Vaccines and Challenges Facing Developers of Anti-HAV Drugs that Prevent HAV Infection
4. Hepatitis E Virus (HEV)
4.1. Diagnosis of Hepatitis E
4.2. Symptoms of HEV Infection
4.3. HEV Genotypes and Clinical Manifestations
4.4. Acute Severe Hepatitis E
4.5. Vaccines and Challenges Facing Developers of Anti-HEV Drugs that Prevent HEV Infection
5. Coinfection with HAV and HEV
6. Discussion
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Item | ALF | ACLF |
Background liver | No liver diseases | Chronic liver diseases or cirrhosis |
Acute insults | ||
HAV | Yes | Yes |
HEV | Yes | Yes |
Chronic liver diseases | ||
HAV | No | No |
HEV | No | Yes (HEV-3 or HEV-4 in immunocompromised patients) |
(A) | |||
Country | Prevalence % (n/Total Patients) | Ref. | Note |
China | HEV (non-pregnant), 30.6% (30/98) | [6] | "Total patients" means all viral-related ALF patients. |
Bangladesh | HEV (non-pregnant), 60.5% (46/76) | [6] | "Total patients" means all viral-related ALF patients. |
India | HAV, 44.2% (81/183) | [58] | "Total patients" means all ALF patients. |
India | HEV (non-pregnant), 40.9% (466/1138) | [6] | "Total patients" means all viral-related ALF patients. |
India | HEV (pregnant women), 71.7% (485/676) | [6] | "Total patients" means all viral-related ALF patients. |
Japan | HAV, 1.5% (77/4994) | [57,140] | "Total patients" means all acute hepatitis A patients (1999–2015). |
Japan | HEV, 3.1% (23/742) | [4,140] | "Total patients" means all acute hepatitis E patients (2010–2015). |
South Korea | HAV, 0.5% (3/595) | [35] | "Total patients" means all acute hepatitis A patients. |
(B) | |||
Country | Prevalence % (n/Total Patients) | Ref. | Note |
APASL | HAV or HEV, 3.1% (118/369) | [141] | "Total patients" means all participants. |
Bangladesh | HEV, 21.7% (15/69) | [99] | "Total patients" means all ACLF patients. |
India | HAV, 27.2% (33/121) | [8] | "Total patients" means all ACLF patients. |
India | HEV, 61.2% (74/121) | [8] | "Total patients" means all ACLF patients. |
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Sasaki-Tanaka, R.; Kanda, T.; Yokoo, T.; Abe, H.; Hayashi, K.; Sakamaki, A.; Kamimura, H.; Terai, S. Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review. Pathogens 2025, 14, 454. https://doi.org/10.3390/pathogens14050454
Sasaki-Tanaka R, Kanda T, Yokoo T, Abe H, Hayashi K, Sakamaki A, Kamimura H, Terai S. Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review. Pathogens. 2025; 14(5):454. https://doi.org/10.3390/pathogens14050454
Chicago/Turabian StyleSasaki-Tanaka, Reina, Tatsuo Kanda, Takeshi Yokoo, Hiroyuki Abe, Kazunao Hayashi, Akira Sakamaki, Hiroteru Kamimura, and Shuji Terai. 2025. "Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review" Pathogens 14, no. 5: 454. https://doi.org/10.3390/pathogens14050454
APA StyleSasaki-Tanaka, R., Kanda, T., Yokoo, T., Abe, H., Hayashi, K., Sakamaki, A., Kamimura, H., & Terai, S. (2025). Hepatitis A and E Viruses Are Important Agents of Acute Severe Hepatitis in Asia: A Narrative Review. Pathogens, 14(5), 454. https://doi.org/10.3390/pathogens14050454