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Hepatitis <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content> virus (<jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content>) infection is believed to be one of the common causes of enterically transmitted acute hepatitis in developing countries and is rare in developed countries, except in patients with a history of travel. However, an increasing number of chronic <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infection cases have recently been reported in developed countries. In these countries, immunosuppressed patients with <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infection, such as organ transplant recipients, human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>)\u2010infected patients or patients with haematological malignancies, could develop chronic hepatitis E (<jats:styled-content style=\"fixed-case\">CHE<\/jats:styled-content>) infection. Approximately 60% of <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infections in immunocompromised patients after solid organ transplantation evolve to <jats:styled-content style=\"fixed-case\">CHE<\/jats:styled-content> without antiviral treatment. Clinical manifestations of <jats:styled-content style=\"fixed-case\">CHE<\/jats:styled-content> are often nonspecific symptoms. Many patients with <jats:styled-content style=\"fixed-case\">CHE<\/jats:styled-content> infection are asymptomatic, but some have jaundice, fatigue, abdominal pain, fever and asthenia. Several extrahepatic manifestations have also been reported. Although chronic <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infection can result in progressive severe liver failure and cirrhosis, diagnosis is often controversial because of the lack of specific diagnostic criteria. Many <jats:styled-content style=\"fixed-case\">CHE<\/jats:styled-content> cases are diagnosed by <jats:styled-content style=\"fixed-case\">HEV RNA<\/jats:styled-content>\u2010positive serum or stool for &gt;6\u00a0months. Immunosuppressive drugs, interferon\u2010alpha and ribavirin have been used for treatment. Diagnostic reverse\u2010transcription polymerase chain reaction is useful for estimating treatment efficacy. Preventive measures for <jats:styled-content style=\"fixed-case\">HEV<\/jats:styled-content> infection have been discussed, while systematic guidelines have not yet been reported.<\/jats:p>","DOI":"10.1111\/jvh.12156","type":"journal-article","created":{"date-parts":[[2013,8,13]],"date-time":"2013-08-13T01:32:47Z","timestamp":1376357567000},"page":"78-89","source":"Crossref","is-referenced-by-count":94,"title":["Chronic hepatitis <scp>E<\/scp>: a review of the literature"],"prefix":"10.1111","volume":"21","author":[{"given":"S.","family":"Fujiwara","sequence":"first","affiliation":[{"name":"Department of Medicine Tohoku University School of Medicine Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Yokokawa","sequence":"additional","affiliation":[{"name":"Department of Medicine Tohoku University School of Medicine Sendai Miyagi 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