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Hepatitis E: Epidemiology, Clinical Course, Prevention, and Treatment. Hepatitis E virus is a common cause of acute hepatitis and acute liver failure in resource-constrained parts of the world. The disease is particularly severe when the infection occurs during pregnancy. In developed countries, human infections occur primarily through zoonotic transmission from animal reservoirs; however, clinical disease is less frequent than in the developing world. The virus strains prevalent in these areas also cause chronic infection in immunocompromised persons, which, if untreated, can progress to cirrhosis; such infection responds well to oral ribavirin. A safe and highly effective recombinant vaccine is available in China, but is not available elsewhere.