Tube must be a dedicated sample.
Centrifuge and separate within 24 hrs of collection.
transport at 4' C if transport time from collection is less than 72 hours.
transport FROZEN if > 72 hours.
Hepatitis E virus is responsible for enterically-transmitted acute hepaititis in humans with two distinct epidemiological patterns. In endemic regions, large waterborne epidemics have been observed with thousands of people affected. In non-epidemic regions, sporadic cases may occur.
4 genotypes of HEV are described. Genotypes 1 and 2 are strictly human infections, genotypes 3 and 4 are found both in humans and other mammals. Infection in domestic and wild pigs is common and pig herds in NZ have a high prevalence of infection. Sporadic cases of HEV have been linked to eating meat from infected animals although in general the source of infection is uncertain.
Infection with genotype 1 or 2 usually causes a self-limiting hepatitis with low mortality except in pregnant women, in whom the mortality may reach 25% especially in the 3 rd trimester. Genotypes 3 and 4 infections are zoonotic with an apparent predilection for elderly men. Symptoms range from inapparent to acute or sub-acute liver failure, with associated neurological symptoms in a minority of patients. Despite earlier belief that HEV was always self-limiting, infection can become chronic in immunosuppressed patients.