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Symptoms of hepatitis E

Alexey Kryvenko, medical expert
Last reviewed: 07.07.2025

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The incubation period has not been precisely established, but there is reason to believe that it ranges from 10 to 40 days, with a maximum of 7 weeks. In a voluntary infection experiment, an incubation period of 36 days was recorded.

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First symptoms of hepatitis E

Symptoms of hepatitis E begin gradually with the appearance of asthenodyspeptic signs. Weakness, increasing over 3-4 days, loss of appetite, nausea, and abdominal pain are noted. An increase in body temperature is observed infrequently. Dark urine appears on the 3-4th day from the onset of the disease. The pre-icteric period lasts from 1 to 10 days. Jaundice can reach its maximum severity within a few hours, but more often develops over 2-3 days. With the appearance of jaundice, the symptoms of intoxication, unlike hepatitis A, do not disappear. Patients continue to feel weakness, poor appetite, complain of pain in the epigastric region and right hypochondrium, and may have itching and subfebrile body temperature. These symptoms of hepatitis E persist for several days after the development of jaundice. Almost all patients in the icteric period have a palpable enlarged liver. An enlarged spleen is observed in 68.6% of cases.

Signs of hepatitis E at the height of the disease

At the height of the icteric period, hyperbilirubinemia is observed - an excess of normal values by 2-10 times, and the conjugated fraction is 1/2-2/3 of the total bilirubin level. Hyperfermentemia can reach high values, while the activity of ALT and AST increases by 5-10 times. The activity of alkaline phosphatase increases. The thymol test values fluctuate within the normal range or increase slightly (no more than 1.5 times). There is a significant decrease in the sublimate titer - below 0.0016 l.

The duration of the icteric period is from 2 to 3 weeks. In the post-icteric period, the liver size gradually normalizes, the indicators of hepatic-cellular enzymes and sediment tests return to normal limits.

For clinical evaluation of this disease, it is advisable to use the generally accepted classification of viral hepatitis. In this case, the type, severity and course of the disease are characterized. With hepatitis E, the most diverse forms of the disease are recorded - from anicteric and erased to severe, cases of malignant forms of the disease have been described.

The course and outcome of hepatitis E

Symptoms of hepatitis E are characterized by an acute course. Histological studies conducted on individual convalescents several months after the disease showed complete morphological reparation of liver tissue. The development of chronic hepatitis as a result of this disease was not observed.