Dalton Harry R, Stableforth William, Thurairajah Prem, Hazeldine Simon, Remnarace Rene, Usama Warshow, Farrington Liz, Hamad Noor, Sieberhagen Cyril, Ellis Vic, Mitchell Jonathan, Hussaini S Hyder, Banks Malcolm, Ijaz Samreen, Bendall Richard P
Cornwall Gastrointestinal Unit, Royal Cornwall Hospital Trust, Truro, Cornwall, UK.
Eur J Gastroenterol Hepatol. 2008 Aug;20(8):784-90. doi: 10.1097/MEG.0b013e3282f5195a.
To report the natural history of autochthonous hepatitis E and hepatitis E virus (HEV) IgG seroprevalence in Southwest England.
Patients with unexplained hepatitis were tested for hepatitis E and cases followed until recovery or death. Five hundred blood donors, 336 individuals over the age of 60 years and 126 patients with chronic liver disease were tested for HEV IgG.
Forty cases of autochthonous hepatitis E (genotype 3) were identified. Hepatitis E was anicteric in 25% of cases and usually caused a self-limiting hepatitis predominantly in elderly Caucasian males. Six of 40 had a significant complication and three patients died, two of who had previously undiagnosed cirrhosis. Hepatitis E shows a seasonal variation with peaks in the spring and summer and no cases in November and December. HEV IgG prevalence increases with age, is more common in men and is 16% in blood donors, 13% in patients with chronic liver disease and 25% in individuals over 60 years.
Autochthonous hepatitis E is more common than previously recognized, and should be considered in the differential diagnosis in patients with hepatitis, whatever their age or travel history. It carries a significant morbidity and when seen in the context of chronic liver disease carries an adverse prognosis.
报告英格兰西南部本土戊型肝炎的自然史及戊型肝炎病毒（HEV）IgG血清阳性率。
对不明原因肝炎患者进行戊型肝炎检测，并对病例进行随访直至康复或死亡。对500名献血者、336名60岁以上个体及126名慢性肝病患者检测HEV IgG。
确诊40例本土戊型肝炎（基因型3）。25%的病例无黄疸，通常主要导致老年白种男性的自限性肝炎。40例中有6例出现严重并发症，3例死亡，其中2例既往有未诊断出的肝硬化。戊型肝炎呈季节性变化，春季和夏季达到高峰，11月和12月无病例。HEV IgG阳性率随年龄增长而升高，男性更常见，献血者中为16%，慢性肝病患者中为13%，60岁以上个体中为25%。
本土戊型肝炎比之前认为的更常见，无论患者年龄或旅行史如何，肝炎患者进行鉴别诊断时均应考虑该病。它具有较高的发病率，在慢性肝病背景下预后不良。
