Key clinical features of hepatitis E in adults typically include an acute, self-limiting hepatitis presentation with symptoms such as jaundice, fatigue, anorexia, nausea, vomiting, abdominal pain, and mild fever. Laboratory findings often show elevated liver enzymes (transaminases) and bilirubin levels. In some cases, especially in pregnant women or those with pre-existing liver disease, hepatitis E can progress to fulminant hepatic failure. Extrahepatic manifestations, including neurological symptoms, have also been reported but are less common Goel & Aggarwal 2016.
Risk factors for diagnosing hepatitis E in adults include recent travel to or residence in endemic areas (such as parts of Asia, Africa, and the Middle East), consumption of contaminated water or undercooked meat (particularly pork or wild game), and exposure to poor sanitation conditions. Immunosuppressed individuals and those with chronic liver disease are at higher risk of severe disease. In the UK context, testing is recommended for adults presenting with acute hepatitis symptoms who have these epidemiological risk factors or unexplained liver dysfunction NICE CG165.
Thus, the diagnosis of hepatitis E in adults relies on recognizing the characteristic clinical syndrome of acute hepatitis combined with relevant epidemiological risk factors and confirmed by serological or molecular testing. The UK guidelines emphasize targeted testing based on risk exposure and clinical presentation NICE CG165, while recent literature highlights the importance of considering extrahepatic manifestations and severe outcomes in vulnerable populations Goel & Aggarwal 2016.