Pischke S, Wedemeyer H
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Minerva Gastroenterol Dietol. 2010 Jun;56(2):121-8.
Hepatitis E is an inflammatory liver disease caused by infection with the hepatitis E virus (HEV). Five different HEV genotypes have been described. While HEV genotypes 1 and 2 primarily infect man, genotypes 3 and 4 have been detected both in humans and several animal species including pigs. HEV genotype 1 and 2 infections are frequent in Southern Asia and Africa. However, Hepatitis E is more and more considered as an re-emerging zoonotic disease also in industrialized countries as HEV genotype 3 infections seem to increase in Western Europe and North America. Acute hepatitis E usually takes an acute self limited course but may take a fulminant course in particular in pregnant women and patients with pre-existing chronic liver disease. Several cases of persistent HEV-infection have been reported in immunosuppressed patients during the last three years being associated with progressive liver disease in some patients. Thus, screening for HEV RNA should be part of the diagnostic work-up of elevated liver transaminases in organ transplantation recipients or HIV-infected individuals. In this review we summarize the recent data on hepatitis E with a particular focus on the importance of persistent HEV infections in liver transplant recipients.
戊型肝炎是一种由戊型肝炎病毒（HEV）感染引起的肝脏炎症性疾病。已描述了五种不同的HEV基因型。虽然HEV 1型和2型主要感染人类，但3型和4型在人类以及包括猪在内的几种动物物种中均有检测到。HEV 1型和2型感染在南亚和非洲很常见。然而，戊型肝炎在工业化国家也越来越被视为一种重新出现的人畜共患病，因为在西欧和北美，HEV 3型感染似乎有所增加。急性戊型肝炎通常呈急性自限性病程，但在孕妇和已有慢性肝病的患者中可能呈暴发性病程。在过去三年中，免疫抑制患者中报告了几例持续性HEV感染病例，其中一些患者与进行性肝病有关。因此，对于器官移植受者或HIV感染者，戊型肝炎病毒RNA筛查应作为肝转氨酶升高诊断检查的一部分。在本综述中，我们总结了戊型肝炎的最新数据，特别关注肝移植受者中持续性戊型肝炎感染的重要性。
