Immunocompetent patients are usually able to clear HEV spontaneously, however, immunocompromised and end-stage liver disease patients may develop chronic hepatitis E. For this last group of patients, treatment is limited, and further studies are required to improve current therapy. Because these patients are at risk of developing complications from the disease, therapy and further investigations may be considered cost-effective.

Blood transfusions represent a rare form of transmission of hepatitis E. Screening of blood donations could help further decrease this risk. However, due to the fact that most patients are asymptomatic, further studies are required to evaluate the cost-effectiveness of this measure.^[1]