Hepatitis E virus: advances and challenges. Author Ila Nimgaonkar, Qiang Ding, Robert Schwartz, Alexander Ploss Publication Year 2018 Type Journal Article Abstract At least 20 million hepatitis E virus (HEV) infections occur annually, with >3 million symptomatic cases and ∼60,000 fatalities. Hepatitis E is generally self-limiting, with a case fatality rate of 0.5-3% in young adults. However, it can cause up to 30% mortality in pregnant women in the third trimester and can become chronic in immunocompromised individuals, such as those receiving organ transplants or chemotherapy and individuals with HIV infection. HEV is transmitted primarily via the faecal-oral route and was previously thought to be a public health concern only in developing countries. It is now also being frequently reported in industrialized countries, where it is transmitted zoonotically or through organ transplantation or blood transfusions. Although a vaccine for HEV has been developed, it is only licensed in China. Additionally, no effective, non-teratogenic and specific treatments against HEV infections are currently available. Although progress has been made in characterizing HEV biology, the scarcity of adequate experimental platforms has hampered further research. In this Review, we focus on providing an update on the HEV life cycle. We will further discuss existing cell culture and animal models and highlight platforms that have proven to be useful and/or are emerging for studying other hepatotropic (viral) pathogens. Keywords Animals, Disease Models, Animal, Cells, Cultured, Viral Proteins, Virion, Hepatocytes, Global Health, Viral Hepatitis Vaccines, Hepatitis E virus, Viral Tropism, Hepatitis E, Pluripotent Stem Cells Journal Nat Rev Gastroenterol Hepatol Volume 15 Issue 2 Pages 96-110 Date Published 2018 Feb ISSN Number 1759-5053 DOI 10.1038/nrgastro.2017.150 Alternate Journal Nat Rev Gastroenterol Hepatol PMID 29162935 PubMedGoogle ScholarBibTeXEndNote X3 XML