Evolving Manifestations of Hepatitis E Virus: Aren’t We Overinterpreting?

Abstract

HEV continues to emerge as a potential human pathogen with novel manifestations, like chronic hepatitis as well as neuropathy and arthralgia. Here, we briefly discuss two recently published reports: the first of an immunocompetent-chronic hepatitis E patient, and the second of an acute hepatitis E patient with rash and arthralgia. The first reported patient had a history of decades-long immunosuppressive therapy for an autoimmune disease that was further continued after the onset of hepatitis E. In the second case, although the hepatitis E patient had serological evidences of past herpes infections, the authors overlooked the fortuitous or indirect association of herpes-related rash and arthralgia. Therefore, such hepatitis E cases need to be a very carefully reported without overstating or overinterpreting the clinical observations.