Hepatitis E infection in chronic liver disease patients causing acute on chronic liver failure: Vaccination is need of the hour

Hepatitis E virus (HEV) infection is a serious global public health illness and one of the major causes of viral hepatitis worldwide.Its prevalence rate globally is under-reported.However, literature has documented an annual incidence of around 20 million people.Approximately 56 000 patients die of HEV-related illnesses every year. 1 HEV infection is acquired through the fecal-oral route secondary to the use of contaminated food and water. 2 Acute hepatitis secondary to HEV infection is usually a self-limiting disease with a similar clinical presentation to that of hepatitis A. 3 HEV infection is also the leading cause of Acute on chronic liver failure (ACLF) in endemic areas. 1 HEV-induced superimposed acute hepatitis in patients having underlying cirrhosis may complicate and worsen the primary disease and can develop a syndrome called ACLF.The sudden deterioration of liver functions in cirrhotic patients is the distinguishing feature of ACLF. 4 The ACLF may progress and involve the other organs, resulting in multiorgan dysfunction. 2The 180-day mortality was showed significantly higher for cirrhotics patients having HEV-induced superimposed