**Question:** All of the following statements are true for hepatitis-E except:

A. Hepatitis-E is caused by the hepatitis E virus (HEV).
B. HEV infection is more common in developed countries.
C. HEV infection is usually asymptomatic in immunocompetent individuals.
D. HEV infection is curable with oral antiviral therapy.

**Core Concept:** Hepatitis-E is a viral infection primarily affecting the liver, caused by the Hepatitis E virus (HEV). Clinical manifestations range from asymptomatic to severe hepatitis, depending on the patient's immune status. Oral antiviral therapy is available for treating HEV infection; however, the statement about its rarity in developed countries and the lack of symptomatic presentation in immunocompetent individuals are not accurate.

**Why the Correct Answer is Right:**

D. HEV infection is curable with oral antiviral therapy is incorrect because oral antiviral therapy is available, but it does not guarantee a complete cure for all cases. Treatment aims to alleviate symptoms and reduce the severity of the disease, but not all patients show a complete recovery. In some cases, the infection may resolve spontaneously or result in prolonged infection or chronic hepatitis E.

**Why Each Wrong Option is Incorrect:**

A. Hepatitis-E is caused by the hepatitis E virus (HEV) is correct, as HEV is the causative agent for hepatitis-E infection.

B. Hepatitis-E is more common in developed countries is incorrect. Hepatitis-E is primarily a disease of developing countries due to poor sanitation, contaminated water, and lack of access to clean drinking water. In developed countries, the infection is less common, usually acquired through foodborne transmission from contaminated food products or through contact with infected animals.

C. Hepatitis-E infection is usually asymptomatic in immunocompetent individuals is incorrect. Although some immunocompetent individuals may remain asymptomatic or have mild disease, the majority of them will develop symptomatic acute hepatitis E. However, the disease can be more severe in immunocompromised patients.

**Clinical Pearls:**

1. Hepatitis E is a significant public health concern in developing countries, where it can lead to acute viral hepatitis and severe outcomes like fulminant hepatitis and liver failure.
2. In developed countries, hepatitis E is less common, often transmitted through contaminated food and contact with infected animals.
3. The severity of hepatitis E varies depending on the patient's immune status. Immunocompetent individuals may have mild disease, while immunocompromised patients are at higher risk for severe disease and complications.