Current global estimates, risk factors, and knowledge gaps for Hepatitis E virus (HEV): A scoping review - PubMed

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Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis globally, especially in South Asia and Africa.
Epidemiological prioritization is hindered by fragmented data and inconsistent disease burden estimates.
A scoping review of global HEV evidence was conducted following JBI and PRISMA-Sc guidelines, focusing on general and high-risk populations, burden estimates, risk factors, and virological gaps.
From 11,583 citations, 395 articles met inclusion criteria, with 65.3% published after 2010, but 54.9% relied on observational descriptive designs.
Three global burden estimates were identified: IHME GBD (19.4 million cases, 2021), and two systematic reviews (20.1 million infections in 2012, 939 million in 2020).
47.8% of studies did not report genotype information, with Genotype 3 being the most frequently identified (21.8%).
Key risk factors include environmental (sanitation/water contamination) and cultural/occupational practices.
High-risk populations include pregnant women, immunocompromised patients, and those with pre-existing liver conditions.
Major knowledge gaps include limited confidence in burden estimates, molecular blind spots, evidence deserts, and insufficient public health resources for surveillance and diagnostics.
HEV is often neglected by international communities and governments due to unreliable burden estimates, hindering prioritization and equitable vaccination strategies.

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