Acute hepatitis E most commonly resolves without specific intervention, but a clinically important subset presents with severe acute disease or progresses to acute-on-chronic liver failure — a high-acuity situation where targeted treatment considerations apply.
In cases of severe acute hepatitis E or acute-on-chronic liver failure, an antiviral agent may be considered. The indication depends on clinical severity; neither the specific agent's dose nor duration has been standardised, and the full decision framework is set out in the structured protocol.
Complete regimen, selection criteria, and clinical algorithm are available in the protocol below.Treatment targets rapid normalisation of liver enzymes and undetectable HEV RNA in blood within a few days of initiating therapy.