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Background: An increasing number of human hepatitis E virus (HEV) infections have been described in the last decade in Europe. In this review, we described the serological data concerning the general population and particular group of patients (i.e immunocompromised patients, pig farmers in different European countries). HEV genotype distribution and anti-HEV therapies are described in the second part of the review. Results: HEV antibody prevalence ranged from 1.3% (blood donors in Italy) to 21.5% (blood donors in Serbia). Only one paper described a seroprevalence of 52% found in blood donors of Toulouse; in this study an assay WANTAI (Wantai Biological Pharmacy, PE2-assay; Beiying, China) with high sensitivity was used. A study carried out in the Netherlands showed that pig veterinarians had a higher anti-HEV IgG prevalence than non-pig veterinarians (11% vs 6%), confirming that pigs represent an important source of HEV infection. Genotypes 3c, 3e, 3f are the main genotypes diffused in Europe, however, sporadic cases of autochthonous genotype 4 have been described in several countries (Spain, France, and Italy). Several cases of fulminant hepatitis E, all related to genotype 3, have been described. Conclusion: The data reported in this review suggests that hepatitis E virus a wide spread infection, even in industrialized countries. The serum prevalence varies greatly, depending on the geographic areas considered and the population studied. Moreover, the seroprevalence may be due to the diagnostic assay used for the detection of antibodies.
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