Epidemiological Peculiarities of the Hepatitis E Virus Infection in Brazil: A Scoping Review

Introduction: Although Brazil has industrialized regions, such as the Southeast, it still has underdeveloped regions with poor sanitary conditions, such as the North and Northeast, similar to regions in Africa and Asia, where HEV-1 circulates. However, it is suspected that HEV occurs as a zoonosis in Brazil. Due to the wide variation in HEV prevalence across the five regions of this country, a scoping review was conducted to systematically identify any the prevalence and genotype of HEV. The following research question was formulated. Aims: to review the epidemiological peculiarities and genotype of HEV in the five regions of Brazil. Methods: This is a scoping review, conducted based on the methodological framework developed by the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The searches were conducted in June and July 2025, using the following databases: MEDLINE and LILACS. A search equation was developed to map the evidence on the epidemiology of HEV infection in Brazil based on the Population, Concept, and Context (PCC) Strategy. Results: Of the 57 studies on the prevalence of hepatitis E virus infection in Brazil, 45 (78.9%) were in humans and 12 (21.1%) in swine. The overall prevalence of the IgG marker in Brazil ranged from 0.5% in the North region to 59.4% in the South region. On the other hand, the lowest prevalence of the IgM marker was recorded in the Northeast region (0.1%) and the highest in the North region (16.3%). Among the 12 studies involving pigs, the occurrence of HEV in these animals was identified in all regions of Brazil, with variations in the types of samples tested, husbandry methods, and prevalence detected. Exclusively hepatitis E viruses belonging to genotype 3 (HEV-3) were identified in all regions of Brazil where genotypic analysis was performed. Conclusion: based on the findings of this review, it can be considered that HEV infection occurs in all five regions of Brazil, with higher prevalence in the South and Southeast regions. The circulating genotype in the country is HEV-3, possibly transmitted through pig consumption and breeding interpretations.