Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Hepatitis E virus (HEV) is endemic in many developing countries responsible for over 50% of cases of acute viral hepatitis. Recent data has shown that HEV is more common worldwide than hepatitis A. Therefore HEV is an important publichealth concern as a major cause of enterically transmitted hepatitis worldwide. While traditionally associated with epidemic outbreaks in the developing world, HEV infection has recently been recognized as a cause of disease cases of sporadic HEV in people in developed countries with no history of recent travel to endemic area (autochthonous infection). HEV infection is far more common than previously thought among immunocompromised and solid organ transplant patients in the developed world. The transmission for HEV is still unclear in most cases with autochthonous infection but risk factors include eating HEV-contaminated pork, other animal meat or their liver products, swine handlers, older age. Chronic HEV infection has been documented in patients receiving immunosuppressive therapy following organ transplantation and results in cirrhosis and graft loss. The lack of an FDA-approved anti-HEV assay and a low index of clinical suspicion have led to a likely underestimation of the burden of HEV infection in North America. HEV infection is still poorly recognized in many parts of the world. Current needs are reliable and validated diagnostic serologic testing and PCR to better detect HEV infection, as this is obviously under-reported. To understand better the burden of disease in North America and the implication of available and effective immunization, epidemiologic studies are required in high risk populations.

Biography

Wikrom Karnsakul?s interests have centered around the understanding and treatment of cholestasis in children, hepatitis E virus infection and metabolic liver diseases. He is also involved in NIH/NIDDK funded multicenter research studies including the Biliary Atresia and Cholestatic Liver Disease Consortium and Cystic Fibrosis related Liver Disease. Other important role as a principal investigator at Johns Hopkins University School of Medicine is to research the prevalence of HEV seropositivity in patients following solid organ transplantation. He currently has applied this knowledge to patients with unknown etiologies of acute or chronic hepatitis including liver transplanted patients.