Overview
Hepatitis E Virus (HEV) is a virus that causes Hepatitis E, a short-term infection of the liver. HEV spreads mainly through contaminated food or water, especially in areas where cleanliness and sanitation are poor. Unlike Hepatitis B or C, Hepatitis E usually does not become chronic, and most people recover completely within a few weeks.
However, the infection can become severe or life-threatening in certain groups, especially:
- Pregnant women (especially in the 3rd trimester)
- People with weak immunity
- People with pre-existing liver disease
Understanding HEV and getting tested at the right time helps prevent complications and ensures proper treatment.
Where HEV Comes From and How It Behaves in the Body
HEV is not produced by the body. It enters through the mouth when a person eats or drinks contaminated food or water. After entering the body:
- HEV travels to the intestine
- From there, it enters the bloodstream
- It reaches and infects the liver cells (hepatocytes)
- The virus multiplies inside the liver, causing inflammation and damage
HEV does not stay dormant like Hepatitis B or C. It usually causes an acute, short-lived infection.
Why HEV Testing Is Important
The Hepatitis E Virus has no helpful role in the body. Testing is important because it helps doctors:
1. Detect Acute Hepatitis
HEV testing confirms whether symptoms like:
- yellow eyes
- dark urine
- loss of appetite
- fever
are caused by Hepatitis E.
2. Differentiate HEV from Other Hepatitis Types
Symptoms of hepatitis A, B, C, and E can be similar.
Testing identifies the exact cause, helping doctors give the right treatment.
3. Prevent Complications in High-Risk Groups
HEV can lead to:
- acute liver failure
- life-threatening complications in pregnant women
- severe disease in people with weak immunity
Early diagnosis is critical in such cases.
4. Stop the Spread of Infection
Knowing you have Hepatitis E helps prevent spreading it to:
- family
- household members
- people who share food or water sources
When HEV Test Shows Low or Negative Results
A negative HEV test means the virus or antibodies were not detected.
Common reasons:
1. No Active Infection
The person has not been infected with HEV.
2. Past Infection Cleared
The body has fought off the infection, and the virus is gone.
3. Early Infection Stage
Testing done too early may not detect:
- HEV antibodies
- HEV RNA
The immune system needs time to produce detectable levels.
Symptoms When Results Are Negative
A negative result usually means everything is normal and the person does not have Hepatitis E.
However:
- If symptoms like jaundice, fever, fatigue, or vomiting are present, it may be too early to detect HEV OR the symptoms may be due to another illness such as hepatitis A or liver problems.
In such cases, repeat testing may be necessary.
When HEV Test Shows High or Positive Results
A positive HEV test means the virus or antibodies against the virus are present.
Reasons include:
1. Active Infection
The person currently has Hepatitis E.
2. Recent Exposure
The virus entered the body recently through contaminated food or water.
3. Rare Chronic Infection
In people with very weak immune systems, HEV may persist for months.
Symptoms When Results Are Positive
People with Hepatitis E may experience:
- Extreme tiredness and weakness
- Loss of appetite
- Nausea and vomiting
- Pain in the upper abdomen (right side where liver is located)
- Dark-colored urine
- Pale or clay-colored stool
- Jaundice (yellow skin and eyes)
- Mild fever
Severe Symptoms (High Risk)
Especially in pregnant women:
- Rapid liver failure
- Excessive vomiting
- Swelling in legs or abdomen
- Bleeding tendencies
Immediate medical care is needed for such symptoms.
Reference Ranges for HEV Tests
Doctors may order multiple tests depending on symptoms:
1. HEV IgM Antibody Test
- Negative → No recent infection
- Positive → Recent or active infection
2. HEV IgG Antibody Test
- Negative → No past exposure
- Positive → Past infection OR immunity
3. HEV RNA Test (PCR)
- Not Detected → No active infection
- Detected → Active Hepatitis E infection
Sample Types Used for HEV Testing
HEV can be detected using:
1. Blood Sample
Used for:
- IgM antibody detection
- IgG antibody detection
- HEV RNA PCR
Most common and reliable.
2. Stool Sample
In certain cases, HEV RNA can be tested in stool, especially during acute phase.
How HEV Test Helps Doctors and Patients
- Confirms the cause of jaundice
- Helps identify contaminated water/food sources
- Prevents severe complications in pregnant women
- Prevents unnecessary treatment for other hepatitis types
- Helps in public health management during outbreaks
Test Preparation
- No fasting required
- Tell your doctor if you are pregnant
- Inform if you take:
- Immunosuppressants
- Steroids
- Anti-rejection drugs (after transplant)
- Drink clean, filtered, or boiled water regularly
- Avoid alcohol before testing as it can interfere with liver symptoms
When to Consult a Doctor
Seek medical help if you have:
- Yellow eyes or skin
- Very dark urine
- Vomiting or inability to eat
- Severe abdominal pain
- Extreme weakness
- Fever with jaundice
- Recent travel to an area with poor sanitation
- Pregnancy with any signs of jaundice
- Immunosuppression (HIV, transplant patients, chemotherapy)
Early diagnosis can prevent liver failure and complications.
Important Word Explanations
- Hepatitis – Inflammation or swelling of the liver
- IgM Antibody – Shows recent or current infection
- IgG Antibody – Shows past infection or immunity
- PCR Test – Detects the genetic material of the virus
- Jaundice – Yellowing of eyes and skin due to liver problems
- Hepatocytes – Liver cells where viruses multiply
- Acute Infection – Short-term, sudden infection
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