Yazbek Soha, Kreidieh Khalil, Ramia Sami
Department of Medical Laboratory Sciences, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Infection. 2016 Feb;44(1):11-22. doi: 10.1007/s15010-015-0807-5. Epub 2015 Jun 26.
Hepatitis E virus (HEV) is mainly transmitted through contaminated water supplies which make the virus endemic in developing countries including countries of the Middle East and North Africa (MENA) region. Recent reports suggest potential risk of HEV transmission via blood transfusion.
Related articles on HEV were collected by searching through the 25 countries of the MENA region using Pubmed and Medline within the past 14 years: January 2000-August 2014.
One hundred articles were extracted, of which 25 were not eligible. The articles discussed the seroprevalence of HEV and HEV markers in 12 countries. Eight articles provided data on HEV in blood donors. The seroprevalence of HEV in the general MENA population ranged from 2.0 to 37.5% and was higher in males than in females. Prevalence increased with age, but exposure seems to be in early life.
In the MENA region, the role of HEV as an infectious threat to blood safety is under-investigated. More data are needed to quantify the risk of transmission and to assess clinical outcomes. This requires, at least, surveillance screening of donors and recipients for HEV markers using sensitive and specific serological tests. At the present time, serious consideration should be given to selective screening for certain groups of patients (e.g., immunocompromised, pregnant women and others) who commonly require blood transfusion and are at high risk of hepatic failure or chronicity from HEV infection.
戊型肝炎病毒（HEV）主要通过受污染的水源传播，这使得该病毒在包括中东和北非（MENA）地区国家在内的发展中国家呈地方性流行。最近的报告表明存在通过输血传播HEV的潜在风险。
通过在过去14年（2000年1月至2014年8月）使用Pubmed和Medline搜索MENA地区的25个国家来收集有关HEV的相关文章。
提取了100篇文章，其中25篇不符合要求。这些文章讨论了12个国家中HEV和HEV标志物的血清流行率。八篇文章提供了献血者中HEV的数据。MENA地区普通人群中HEV血清流行率在从至37.5%之间，男性高于女性。患病率随年龄增长而增加，但感染似乎发生在早年。
在MENA地区，HEV对血液安全作为一种感染威胁的作用研究不足。需要更多数据来量化传播风险并评估临床结果。这至少需要使用敏感和特异的血清学检测对献血者和受血者进行HEV标志物的监测筛查。目前，应认真考虑对某些通常需要输血且有因HEV感染导致肝衰竭或慢性化高风险的患者群体（如免疫功能低下者、孕妇等）进行选择性筛查。
