Hepatitis E symptoms

What are the symptoms?

The symptoms of hepatitis E are relatively unspecific and are similar to those of hepatitis A. An infection often runs without symptoms (asymptomatic) and goes unnoticed by those affected. The general symptoms include:

  • flu-like symptoms

  • fever

  • Nausea and vomiting

  • diarrhea

  • a headache

  • Fatigue and exhaustion

  • Pain in the upper right abdomen

  • Jaundice (yellowing of the skin and the whites of the eyes)

  • light, colorless chair

  • dark urine

Flu-like symptoms

An acute hepatitis E infection can lead to flu-like symptoms. Those affected complain of a strong feeling of illness, headache and body aches as well as nausea. Fever attacks with temperatures of up to 40 degrees can also occur.

The inflamed liver is often not painful, so an infection with hepatitis E can go undetected and be mistaken for the flu. If, in addition to the flu-like symptoms, there are other signs such as yellowing of the skin, colorless stools, dark urine or dull pain in the right upper abdomen, this speaks for an inflammation of the liver. In such cases a doctor should be consulted.

Read more on this topic: Flu symptoms

Pain in the upper right abdomen

The liver is a very large organ located in the upper right abdomen. An infection with the hepatitis E virus causes the liver to become inflamed, causing pain in the upper right abdomen. The liver itself is not innervated by nerves that lead to the sensation of pain and therefore does not hurt directly. However, the organ is embedded in a covering made of connective tissue, the so-called liver capsule. The inflamed liver swells and presses against the capsule, causing dull tenderness to pressure. Upper right abdominal pain is a common symptom of inflammation of the liver.

Light chair

The liver has important detoxification and conversion functions in the human body and excretes waste products from the metabolism, toxins and drugs via the bile. In addition, the bile pigment bilirubin is produced in the liver and released into and excreted in the intestine via the bile. In the intestine, bilirubin is converted by bacteria, giving the stool its characteristic brown color. An infection with hepatitis E causes the liver to become inflamed and its function is restricted, which means that sufficient bilirubin can no longer be released into the bile. As a result, the chair loses its brown color and becomes gray or colorless.

Read more on this topic: Function of the liver

Dark urine

As a result of infection with hepatitis E, the inflamed liver can no longer excrete sufficient amounts of the bile pigment bilirubin in the bile, which causes bilirubin to accumulate in the blood. Some of the accumulated bilirubin can be excreted through the kidneys, turning the urine dark. A dark discoloration of the urine can therefore be a sign of hepatitis E disease.

Nausea and vomiting

If you suffer from hepatitis E, the inflamed liver can no longer work properly and no longer produces enough bile. The biliary obstruction leads to digestive problems such as nausea, vomiting and diarrhea. These symptoms are common side effects of hepatitis E infection.


Patients who have contracted the hepatitis E virus often experience fever and flu-like symptoms. The body's immune system reacts to the pathogens and specifically produces antibodies that can trigger a fever to fight the infection. Fever over 39 degrees, sweating and chills are therefore often early symptoms of an acute hepatitis E infection.

Jaundice / yellowing of the eyes

With hepatitis E, jaundice (jaundice) can develop. Due to the inflammation, the liver can no longer release the yellow bile pigment bilirubin to the bile and thus excrete it from the body through the stool. Bilirubin eventually builds up in the body and causes yellowing of the skin and sclera (the white connective tissue of the eyeballs). Jaundice is a clear symptom of liver damage and should see a doctor immediately if this symptom occurs.

How long is the incubation period before symptoms break out after infection?

The incubation period, i.e. the time between infection and the onset of the first symptoms, is between 15 and 50 days for an infection with the hepatitis E virus. Many infections run without symptoms and those affected do not notice that they have hepatitis E. In such cases, hepatitis E heals spontaneously after a few weeks.

Can the symptoms become chronic?

Hepatitis E usually heals on its own after a few weeks. Most infected people are symptom-free and completely healthy again after about one to two months.

Chronic hepatitis is when the inflammation persists for several months. So far, however, no chronic courses of hepatitis E have been observed in people with an intact immune system. Chronification occurs only in immunosuppressed patients (e.g. after an organ transplant, patients with HIV, patients who require dialysis) and, in severe cases, can lead to liver cirrhosis and permanent damage to the liver.