Dalton H R, Stableforth W, Hazeldine S, Thurairajah P, Ramnarace R, Warshow U, Ijaz S, Ellis V, Bendall R
Royal Cornwall Hospital Trust, Truro, Cornwall, UK.
Eur J Clin Microbiol Infect Dis. 2008 Jul;27(7):579-85. doi: 10.1007/s10096-008-0480-z. Epub 2008 Feb 26.
The incidence of hepatitis A is falling. In contrast, autochthonous hepatitis E is an emerging infection in developed countries. The objective of this study was to compare both laboratory-confirmed cases of hepatitis A and autochthonous hepatitis E over a 2-year period in Cornwall and Devon and anti-hepatitis A virus (HAV) IgG and anti-hepatitis E virus (HEV) IgG seroprevalence in blood donors. The databases of microbiology laboratories in Cornwall and Devon were searched for the number of diagnostic HEV and HAV assays performed during 2005-2006 and the number of confirmed cases of acute hepatitis A and hepatitis E detected. Patients were followed up until recovery or death. Sera from 500 blood donors from the regional centre were tested for HEV and HAV IgG. In total, 28 cases of autochthonous hepatitis E were identified from 838 assays, and 20 cases of hepatitis A were identified from 4503 assays. Compared to hepatitis A cases, patients with hepatitis E were older (mean age 61 vs. 45 years, P = 0.003), less likely to present in winter (P = 0.028) and had more complications (five vs. one). The IgG seroprevalence rates in blood donors were 45% for HAV and 16% for HEV. There was no relationship between HAV and HEV IgG seropositivity. Autochthonous hepatitis E may be more common than hepatitis A, affects older patients, is less likely to occur in winter and may be associated with more complications. Patients with acute hepatitis, whatever their age or travel history, should be tested for HEV.
甲型肝炎的发病率正在下降。相比之下，本土戊型肝炎在发达国家是一种新出现的感染性疾病。本研究的目的是比较康沃尔郡和德文郡两年内实验室确诊的甲型肝炎病例和本土戊型肝炎病例，以及献血者中抗甲型肝炎病毒（HAV）IgG和抗戊型肝炎病毒（HEV）IgG的血清阳性率。检索了康沃尔郡和德文郡微生物实验室的数据库，以获取2005 - 2006年期间进行的戊型肝炎病毒和甲型肝炎病毒诊断检测数量，以及检测到的急性甲型肝炎和戊型肝炎确诊病例数量。对患者进行随访直至康复或死亡。对来自该地区中心的500名献血者的血清进行了戊型肝炎病毒和甲型肝炎病毒IgG检测。从838次检测中总共鉴定出28例本土戊型肝炎病例，从4503次检测中鉴定出20例甲型肝炎病例。与甲型肝炎病例相比，戊型肝炎患者年龄更大（平均年龄61岁对45岁，P = 0.003），冬季发病的可能性较小（P = 0.028），并且并发症更多（分别为5例和1例）。献血者中甲型肝炎病毒IgG血清阳性率为45%，戊型肝炎病毒IgG血清阳性率为16%。甲型肝炎病毒和戊型肝炎病毒IgG血清阳性之间没有关联。本土戊型肝炎可能比甲型肝炎更常见，影响老年患者，冬季发病可能性较小，并且可能与更多并发症相关。无论年龄或旅行史如何，急性肝炎患者都应进行戊型肝炎病毒检测。
