The hepatitis E virus (HEV) was initially thought to exclusively cause acute hepatitis. However, the first diagnosis of chronic hepatitis E in transplant recipients in 2008 profoundly changed our understanding of this pathogen. We have now begun to understand that specific HEV genotypes can cause chronic infection in certain immunocompromised populations. Over the past decade, dedicated clinical and experimental research has substantiated knowledge on the epidemiology, transmission routes, pathophysiological mechanisms, diagnosis, clinical features and treatment of chronic HEV infection. Nevertheless, many gaps and major challenges remain, particularly regarding the translation of knowledge into disease prevention and improvement of clinical outcomes. This article aims to highlight the latest developments in the understanding and management of chronic hepatitis E. More importantly, we attempt to identify major knowledge gaps and discuss strategies for further advancing both research and patient care.

戊型肝炎病毒 (HEV) 最初被认为只引起急性肝炎。然而，2008 年移植受者首次诊断出慢性戊型肝炎，深刻地改变了我们对这种病原体的认识。我们现在已经开始了解特定的 HEV 基因型会导致某些免疫功能低下人群的慢性感染。在过去的十年中，专门的临床和实验研究证实了慢性 HEV 感染的流行病学、传播途径、病理生理机制、诊断、临床特征和治疗方面的知识。然而，仍然存在许多差距和重大挑战，特别是在将知识转化为疾病预防和改善临床结果方面。