Hepatitis E
In this section:
- What is hepatitis E?
- How common is hepatitis E?
- Who is more likely to have hepatitis E symptoms?
- What are the complications of hepatitis E?
- What are the symptoms of hepatitis E?
- What causes hepatitis E?
- How do doctors diagnose hepatitis E?
- How do doctors treat hepatitis E?
- Is a hepatitis E vaccine available?
- How can I protect myself from hepatitis E infection?
- How can I prevent spreading hepatitis E to others?
- What should I eat and drink if I have hepatitis E?
- Clinical Trials for Hepatitis E
What is hepatitis E?
Hepatitis E is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.
Viruses invade cells in your body. The hepatitis E virus has different forms, called genotypes, that spread in different ways.
The most common hepatitis E genotypes are spread by drinking contaminated water. Rarer genotypes infect pigs and some wild animals. People may become infected by these genotypes if they eat undercooked pork or wild game, such as boar and deer. People may also become infected if they consume water that has come in contact with stool from an infected animal.
There is currently no vaccine available for hepatitis E in the United States. You can take steps to protect yourself from hepatitis E. In the United States, hepatitis E is not commonly spread from person to person.
The hepatitis E virus can cause an acute or chronic infection.
Acute hepatitis E
The hepatitis E virus usually causes an acute infection. Acute hepatitis E is an infection that only lasts a short time, and then the virus goes away. In some cases, acute hepatitis E can be severe and lead to problems, such as acute liver failure.
Chronic hepatitis E
Chronic hepatitis E is a long-lasting infection. Chronic hepatitis E occurs when the virus stays in your body and doesn’t go away.
Chronic hepatitis E is rare and typically occurs only in developed nations. Most people with chronic hepatitis E have weakened immune systems. This may include people who are receiving certain cancer treatments, are taking medicines to prevent organ transplant rejection, or have HIV.1,2
How common is hepatitis E?
Hepatitis E is the most common type of viral hepatitis in the world. Different hepatitis E genotypes are less common in the United States than in some other parts of the world.
Hepatitis E worldwide
The most common hepatitis E genotypes—which are spread by drinking contaminated water— are more common where sanitation and access to clean water are limited, including parts of Asia, Africa, and Central America. The World Health Organization estimates that more than 20 million people around the world are infected every year.3
Hepatitis E in the United States
Rarer hepatitis E genotypes spread in the United States and some other developed nations. These genotypes are spread by eating undercooked pork or wild game or by consuming water that has come in contact with stool from an infected animal.
Research suggests that up to 21% of people in the United States have been infected with hepatitis E at some point in their lives.4 Most people don’t know they had been infected because they had no symptoms.
Who is more likely to have hepatitis E symptoms?
The forms of hepatitis E that are common in developing nations are more likely to cause symptoms in people between ages 15 and 44.1 Children are also affected by these forms of hepatitis E, but many have mild or no symptoms.
The forms of hepatitis E that affect people in some developed nations most often cause no symptoms. However, men over age 60 and people with weakened immune systems are more likely to have hepatitis E symptoms.4 Hepatitis E infection is also more common in people who have hepatitis C and other chronic liver diseases.
What are the complications of hepatitis E?
Acute hepatitis E complications
People with acute hepatitis E most often get better without complications.
In some severe cases, acute hepatitis E may cause acute liver failure, a condition in which the liver suddenly stops working properly. Acute liver failure due to hepatitis E is more common in developing nations and in certain groups, including
- pregnant women
- people who have other liver diseases
Hepatitis E can cause other complications for women and their babies, such as stillbirth, premature birth, or low birthweight.
Chronic hepatitis E complications
Although chronic hepatitis E is rare, it can lead to health problems such as cirrhosis or liver failure.
What are the symptoms of hepatitis E?
Many people infected with hepatitis E have no symptoms. Other people begin to have symptoms 15 to 60 days after they become infected with the virus.1 These symptoms can include
- darker urine color and lighter stool color
- fatigue, or feeling tired
- fever
- joint pain
- loss of appetite, nausea, and vomiting
- pain in the abdomen
- yellow tint to the eyes and skin, called jaundice
People with hepatitis E typically get better without treatment after several weeks.
What causes hepatitis E?
The hepatitis E virus causes hepatitis E. In nations where access to clean water is limited, hepatitis E typically spreads when people drink untreated water. Water can become contaminated when it comes in contact with stool from people who are infected with the virus.
In the United States and some other developed nations, hepatitis E can spread when people eat food contaminated with the virus, such as raw or undercooked pork or deer meat. Hepatitis E may also spread when people consume water that has come in contact with stool from an infected animal.
Research suggests that hepatitis E can also spread through blood transfusion, but this is very rare.5
How do doctors diagnose hepatitis E?
Doctors diagnose hepatitis E based on symptoms and blood tests. A health care professional will take a blood sample from you and send the sample to a lab. Blood tests can detect antibodies to the hepatitis E virus and show whether you have had hepatitis E.

How do doctors treat hepatitis E?
To treat acute hepatitis E symptoms, your doctor may suggest getting plenty of rest, drinking plenty of liquids, and consuming healthy foods and drinks. In some cases, doctors prescribe medicines to treat chronic hepatitis E. See your doctor regularly to make sure you have fully recovered.
Check with your doctor before taking any prescription or over-the-counter medicines. For safety reasons, talk with your doctor before using dietary supplements, such as vitamins or complementary or alternative medicines or medical practices. Some of these could lead to liver damage. You should also avoid alcohol until your doctor tells you that you have completely recovered from hepatitis E.
Is a hepatitis E vaccine available?
No vaccine for hepatitis E is available in the United States. Vaccines have been developed and are used in China.
How can I protect myself from hepatitis E infection?
When traveling in a developing nation, drink bottled water and use it to brush your teeth, make ice cubes, and wash fruits and vegetables.
Also, make sure any meat you eat is thoroughly cooked, both in developing nations and in developed nations, such as the United States.

How can I prevent spreading hepatitis E to others?
It’s uncommon for people to spread hepatitis E directly to other people. If you have hepatitis E, you can reduce your chance of spreading the infection by washing your hands with soap and water after using the toilet and before preparing food. If you don’t have soap and water available, use a hand sanitizer that is at least 60% alcohol. Talk with a blood donation center before you donate blood.
What should I eat and drink if I have hepatitis E?
If you have hepatitis E, you should choose healthy food and drinks. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.
Clinical Trials for Hepatitis E
NIDDK conducts and supports clinical trials in many diseases and conditions, including liver diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.
What are clinical trials for hepatitis E?
Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.
Find out if clinical studies are right for you.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
What clinical studies for hepatitis E are looking for participants?
You can find clinical studies on hepatitis E at ClinicalTrials.gov. In addition to searching for federally funded studies, you can expand or narrow your search to include clinical studies from industry, universities, and individuals; however, the National Institutes of Health does not review these studies and cannot ensure they are safe for you. Always talk with your health care provider before you participate in a clinical study.
References
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
NIDDK would like to thank:
Kenneth Sherman, M.D., Ph.D., University of Cincinnati