Renou C, Nicand E, Pariente A, Cadranel J-F, Pavio N
Hôpital de Jour, centre hospitalier de Hyères, rue du Maréchal-Juin, Hyères, France.
Gastroenterol Clin Biol. 2009 Oct;33(10-11 Suppl):F27-35. doi: 10.1016/j.gcb.2009.07.026. Epub 2009 Sep 16.
In developed countries, HEV infection was still recently considered as rare, and as an imported disease from endemic areas by travellers. Hepatitis E virus is now recognized mainly as an autochthonous disease in these countries. Although the source and the route of contamination remain uncertain, several cases of food-borne (zoonotic transmission) and blood-borne transmission have been recently reported. The mortality rates in industrialized countries seems to be higher than in endemic areas, since the infection occurs more frequently in elderly people with underlying chronic liver disease (mortality rate approaching 70% in this subgroup of patients). By contrast, whereas mortality rate rises by 20% during pregnancy in developing countries, no death in pregnant woman from developed countries secondary to an autochthonous case has been reported so far. Lastly, HEV infection may be a cause of chronic hepatitis in immunocompromised patients (mostly in solid organ-transplant recipients) which can evolve to cirrhosis.
在发达国家，戊型肝炎病毒（HEV）感染直到最近仍被认为较为罕见，被视为旅行者从流行地区输入的疾病。如今，戊型肝炎病毒在这些国家主要被认定为本土疾病。尽管感染源和传播途径仍不明确，但最近已有几例食源性（人畜共患病传播）和血源性传播的病例报告。工业化国家的死亡率似乎高于流行地区，因为感染在患有潜在慢性肝病的老年人中更为常见（该亚组患者的死亡率接近70%）。相比之下，发展中国家孕妇的死亡率在孕期会上升20%，而迄今为止，尚未有发达国家孕妇因本土感染病例而死亡的报告。最后，戊型肝炎病毒感染可能是免疫功能低下患者（主要是实体器官移植受者）慢性肝炎的病因，这种慢性肝炎可能会发展为肝硬化。
