HEPATITIS E VIRUS • HEV is a major cause of hepatitis transmitted by the fecal-oral route. • It is thought to be more common than HAV in many developing countries. • . • Properties:HEV is a nonenveloped, single-stranded RNA virus classified as a member of the hepevirus family. • Clinical features: Clinically, the disease resembles hepatitis A, with the exception of a high mortality rate in pregnant women. Most cases resolve without sequelae. • Chronic infection resulting in chronic hepatitis and cirrhosis, but not HCC, occurs in immunocompromised individuals such as HIV-infected patients, those who are receiving cancer chemotherapy, and patients who are receiving immuno- suppressive drugs to prevent rejection of solid organ transplants. • Diagnosis:The diagnosis is typically made by detecting IgM antibody to HEV. A PCR assay that detects HEV RNA in patient specimens is available. • Prevention and Treatment : There is no antiviral drug available for acute infection in immunocompetent patients. In immunocompromised patients, ribavirin cleared HEV viremia in solid organ transplant recipients. There is no vaccine