Dalton Harry R, Bendall Richard, Ijaz Samreen, Banks Malcolm
Peninsula College of Medicine and Dentistry, Royal Cornwall Hospital Trust, Truro, UK.
Lancet Infect Dis. 2008 Nov;8(11):698-709. doi: 10.1016/S1473-3099(08)70255-X.
Hepatitis E is endemic in many developing countries where it causes substantial morbidity. In industrialised countries, it is considered rare, and largely confined to travellers returning from endemic areas. However, there is now a growing body of evidence that challenges this notion. Autochthonous hepatitis E in developed countries is far more common than previously recognised, and might be more common than hepatitis A. Hepatitis E has a predilection for older men in whom it causes substantial morbidity and mortality. The disease has a poor prognosis in the context of pre-existing chronic liver disease, and is frequently misdiagnosed as drug-induced liver injury. The source and route of infection remain uncertain, but it might be a porcine zoonosis. Patients with unexplained hepatitis should be tested for hepatitis E, whatever their age or travel history.
戊型肝炎在许多发展中国家呈地方性流行，在这些国家它会导致大量发病情况。在工业化国家，戊型肝炎被认为较为罕见，主要局限于从流行地区返回的旅行者。然而，现在有越来越多的证据对这一观念提出了挑战。发达国家的本土戊型肝炎比以前认为的要普遍得多，而且可能比甲型肝炎更常见。戊型肝炎在老年男性中更为常见，会导致大量发病和死亡。在已有慢性肝病的情况下，该疾病预后较差，并且经常被误诊为药物性肝损伤。感染源和传播途径仍不确定，但它可能是一种猪源性人畜共患病。无论年龄或旅行史如何，病因不明的肝炎患者都应进行戊型肝炎检测。
