Assessing the Global Burden of Hepatitis E Virus Associated with Genotypes 1, 2, 3 and 4

Abstract

Globally, policy recommendations on vaccines as provided by the Strategic Group of Experts on Immunization (SAGE) rely on a number of factors including burden of disease. In the scope of this thesis, two studies were conducted in order to inform the World Health Organization Hepatitis E Virus (HEV) working group and ultimately the SAGE: 1) a systematic review and meta-analysis of the global incidence, prevalence and mortality associated with all genotypes of HEV; and 2) a global subgroup analysis of incidence, prevalence and mortality on special populations and high risk populations. Circulation of HEV was documented in all global regions. Severe disease was observed among pregnant women and fulminant hepatic failure patients in both studies conducted. Poor data quality was observed in both studies, this poses a serious challenge for estimating the burden of disease. Countries should consider the implementation of an HEV surveillance system to improve data quality and ultimately to inform decision-making.