الفهرس 
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Abstract
In areas with tropical or subtropical climate and poor sanitary conditions, hepatitis E is the major cause of enterically transmitted non-A, non-B hepatitis, and is responsible for both water-borne outbreaks and sporadic cases of acute hepatitis. One of the major charachteristic of this virus is that it has high mortality rate with pregnant women especially if they are in the last trimaetser.
Aim of the Work
This cohort study aims to evaluate retrospectively the prevalence and incidence of HEV in some governorates of Egypt that have different ecology including water source. The possibility of coinfection with other hepatic viruses was also evaluated.
Subjects & Methods
1) Serum samples were collected from (5103) participants in the study from three Egyptian governorates with all their data.
2) Second samples were collected after one year of the initial samples.
3) Serological assays for other Hepatitis markers (A, B, C) were done.
4) Liver and Kidney function tests were evaluated in some of the participants.
Results:
Serum samples were collected from (5103) participants during the first year and from (3079) participants during the second year. Prevalence rate of Hepatitis E virus within all of the participants was (23%), with intergovernorate difference. Fayoum showed the highest prevalence rate (33.1%), then Qena (19.6%), then ZagZig (16.2%).
The rate of HEV infection after one year among HEV negative participants was 4.7%.
The seroprevalence rate of HEV was peaking at the fifth and sixth decade in both initial and seroconverted participants.
The seroprevalence rate of HEV was generally higher in females than males.
The seroprevalence of HEV is associated with both drinking and washing water source with highest infection rate among people using municipal water tap inside the house.
All participants 100% had anti-HAV IgG.
The seroprevalence of HBcAb was 28.5% among all participants and dual infection with HEV was 31.2%.
The seroprevalence of HCV was 16.9% among all participants and dual infection with HEV was 19.2%.
Level of both ALT and AST increased with the increase in the number of viral infection.
All biochemical markers were elevated in HEV seroconverted participants.
Conclusions:
HEV is endemic in Egypt especially in elderly people in both genders and is related to different sources of drinking and washing. Dual viral infections with other hepatitis viruses were also evaluated.