Okamoto Hiroaki, Takahashi Masaharu, Nishizawa Tsutomu
Division of Virology, Department of Infection and Immunity, Jichi Medical School, 3311-1, Yakushiji, Minamikawachi-machi, Tochigi.
Intern Med. 2003 Nov;42(11):1065-71. doi: 10.2169/internalmedicine.42.1065.
Hepatitis E virus (HEV) is a major cause of acute hepatitis in many developing countries. HEV is transmitted principally by the fecal-oral route, and water-borne epidemics are characteristic of hepatitis E. Recently, there is growing consensus that HEV-associated hepatitis also occurs among individuals in industrialized nations who had no history of travel to endemic areas. Zoonotic spread of HEV has been suggested as human and swine HEV strains are closely related genetically and experimental cross-species infection of swine HEV to a chimpanzee and that of human HEV to swine have been demonstrated. This review describes the clinical, epidemiological and virological characteristics of domestic HEV infection in Japan, the genetic relatedness of Japanese human and swine HEV strains, and possible modes of HEV transmission, emphasizing that HEV should be considered in the diagnosis of acute or fulminant hepatitis of non-A, non-B, non-C etiology, even in patients who have not traveled abroad.
戊型肝炎病毒（HEV）是许多发展中国家急性肝炎的主要病因。HEV主要通过粪-口途径传播，水源性流行是戊型肝炎的特征。最近，越来越多的人达成共识，即戊型肝炎相关肝炎也发生在没有前往流行地区旅行史的工业化国家的个体中。由于人类和猪的HEV毒株在基因上密切相关，并且已经证明猪HEV可通过实验性跨物种感染黑猩猩，人类HEV可感染猪，因此有人提出HEV的人畜共患病传播。这篇综述描述了日本国内HEV感染的临床、流行病学和病毒学特征，日本人类和猪HEV毒株的基因相关性，以及HEV可能的传播方式，强调即使在没有出国旅行的患者中，在诊断非甲、非乙、非丙型病因的急性或暴发性肝炎时也应考虑HEV。
