Pérez-Gracia María Teresa, Rodríguez-Iglesias Manuel
Departamento de Atención Sanitaria, Salud Pública y Sanidad Animal. Universidad Cardenal Herrera-CEU. Moncada. Valencia. España.
Med Clin (Barc). 2003 Dec 6;121(20):787-92.
In areas with tropical or subtropical climate and poor sanitary conditions, hepatitis E is the major cause of enterically transmitted non-A, non-B hepatitis, and is responsible for both water-borne outbreaks and sporadic cases of acute hepatitis. The causative agent is the hepatitis E virus (HEV), a non-enveloped, single-stranded, positive-sense RNA molecule of an approximately 7.2 kb length. Recently, HEV strains have been isolated in swine in industrialized countries. In addition, cases of acute hepatitis due to novel HEV variants have been reported in humans without recognized risk factors for hepatitis E in Europe, Japan and the US. Some of the novel strains were found to be closely related to swine HEV isolates from the same area, suggesting that hepatitis E is a zoonotic disease. Thus hepatitis E is becoming a concern in countries where HEV is not, traditionally, believed to be endemic. This review summarizes the current knowledge of the biology, structure and transmission of the virus as well as the diagnosis of the infection. We also analyze the present status in areas with a low incidence of acute hepatitis E and the role of animals as potencial vectors of the virus.
在热带或亚热带气候且卫生条件较差的地区,戊型肝炎是经肠道传播的非甲非乙型肝炎的主要病因,可导致水源性暴发以及急性肝炎散发病例。病原体是戊型肝炎病毒(HEV),它是一种无包膜的单链正链RNA分子,长度约为7.2 kb。最近,在工业化国家的猪身上分离出了戊型肝炎病毒株。此外,在欧洲、日本和美国,已报告了由新型戊型肝炎病毒变异株引起的急性肝炎病例,这些病例的患者并无公认的戊型肝炎风险因素。一些新型毒株被发现与同一地区猪的戊型肝炎病毒分离株密切相关,这表明戊型肝炎是一种人畜共患病。因此,在传统上不认为戊型肝炎为地方性疾病的国家,戊型肝炎正日益受到关注。本综述总结了关于该病毒的生物学、结构和传播以及感染诊断的当前知识。我们还分析了急性戊型肝炎低发地区的现状以及动物作为该病毒潜在传播媒介的作用。