Krawczynski K, Mast E E, Purdy M A
Hepatitis Branch, Division of Viral and Rickettsial Disease, National Center for Infectious Disease Control and Prevention, Atlanta, GA 30333, USA.
Minerva Gastroenterol Dietol. 1999 Jun;45(2):119-30; discussion 130-5.
Hepatitis E is an enterically transmitted, acute, self-limited, icteric viral disease that occurs in large numbers in countries of the Indian subcontinent, Asia, and Africa. The frequency of epidemics and the high mortality rate among infected pregnant women are strong indicators that hepatitis E is an important cause of morbidity and mortality in humans. Several isolates of hepatitis E virus (HEV) derived from infected humans and experimental animals have recently been cloned and sequenced, allowing investigators to determine the molecular structure of the HEV genome. Laboratory diagnosis of HEV infection is done by detection of HEV antibodies, HEV RNA in stool and serum samples, HEV particles in stool specimens, and HEV antigen in hepatocytes and stool specimens. The detection of anti-HEV by enzyme immunoassay, with the use of several recombinant HEV proteins or synthetic peptides, is the most frequently applied method for the diagnosis of the infection and characterization of its epidemiologic features. Laboratory determination of HEV replication, immune response, and liver pathologic features in patients with hepatitis E and in infected primates has facilitated studies of the disease. Preventive measures against HEV infection include the passive transfer of protective antibodies or active immunization. In efforts to develop HEV vaccines, various recombinant proteins have been used. Although a range of protective immune responses have been induced in primates, further modifications of immunogen, adjuvant, and immunization schedules are necessary to prevent HEV infection. Much remains to be learned about epidemiology of HEV infection, reservoir(s) of the virus, and protective immunity in order to develop effective strategies to prevent hepatitis E.
戊型肝炎是一种经肠道传播的急性自限性黄疸型病毒性疾病，在印度次大陆、亚洲和非洲国家大量发生。疫情的频发以及感染孕妇的高死亡率有力地表明，戊型肝炎是人类发病和死亡的重要原因。最近，从感染人类和实验动物中分离出的几种戊型肝炎病毒（HEV）毒株已被克隆和测序，这使研究人员能够确定HEV基因组的分子结构。戊型肝炎病毒感染的实验室诊断通过检测HEV抗体、粪便和血清样本中的HEV RNA、粪便标本中的HEV颗粒以及肝细胞和粪便标本中的HEV抗原进行。使用几种重组HEV蛋白或合成肽，通过酶免疫测定法检测抗HEV，是诊断感染及其流行病学特征最常用的方法。对戊型肝炎患者和感染灵长类动物的HEV复制、免疫反应和肝脏病理特征进行实验室测定，有助于对该疾病的研究。预防戊型肝炎病毒感染的措施包括被动转移保护性抗体或主动免疫。在开发戊型肝炎疫苗的努力中，已使用了各种重组蛋白。尽管在灵长类动物中诱导了一系列保护性免疫反应，但仍需要对免疫原、佐剂和免疫接种方案进行进一步改进，以预防戊型肝炎病毒感染。为了制定有效的戊型肝炎预防策略，关于戊型肝炎病毒感染的流行病学、病毒宿主和保护性免疫仍有许多需要了解的地方。
