Khuroo Mehnaaz S, Khuroo Mohammad S
Department of Pathology, Govt: Medical College Srinagar, Kashmir, India.
Gastroenterology and Chairman Dept. Medicine, Sher-i-Kashmir Institute of Medical Sciences, Kashmir, India.
J Viral Hepat. 2016 Feb;23(2):68-79. doi: 10.1111/jvh.12445. Epub 2015 Sep 6.
Hepatitis E is a systemic disease affecting the liver predominantly and caused by infection with the hepatitis E virus (HEV). HEV has marked genetic heterogeneity and is known to infect several animal species including pigs, boar, deer, mongoose, rabbit, camel, chicken, rats, ferret, bats and cutthroat trout. HEV is the sole member of the family Hepeviridae and has been divided into 2 genera: Orthohepevirus (mammalian and avian HEV) and Piscihepevirus (trout HEV). Human HEVs included within the genus Orthohepevirus are designated Orthohepevirus A (isolates from human, pig, wild boar, deer, mongoose, rabbit and camel). Hepatitis E is an important public health concern, and an estimated one-third of the world population has been infected with HEV. In recent years, autochthonous hepatitis E is recognized as a clinical problem in industrialized countries. Several animal species especially domestic swine, wild boar and wild deer are reservoirs of genotype HEV-3 and HEV-4 in these countries. Human infections occur through intake of uncooked or undercooked meat of the infected animals and pig livers or sausages made from these livers and sold in supermarkets. HEV can be transmitted through blood and blood component transfusions, and donor screening for HEV is under serious consideration. Chronic hepatitis E resulting in rapidly progressive liver cirrhosis and end-stage liver disease has been described in organ transplant patients. Ribavirin monotherapy attains sustained virological response in most patients. HEV 239 vaccine has been marketed in China and its long-term efficacy over four and a half years reported.
戊型肝炎是一种主要影响肝脏的全身性疾病，由戊型肝炎病毒（HEV）感染引起。HEV具有显著的遗传异质性，已知可感染多种动物，包括猪、野猪、鹿、獴、兔、骆驼、鸡、大鼠、雪貂、蝙蝠和虹鳟鱼。HEV是戊型肝炎病毒科的唯一成员，已分为2个属：正戊型肝炎病毒属（哺乳动物和禽类HEV）和鱼戊型肝炎病毒属（鳟鱼HEV）。正戊型肝炎病毒属中的人类HEV被指定为正戊型肝炎病毒A（从人类、猪、野猪、鹿、獴、兔和骆驼中分离出的毒株）。戊型肝炎是一个重要的公共卫生问题，估计全球三分之一的人口已感染HEV。近年来，散发性戊型肝炎在工业化国家被认为是一个临床问题。在这些国家，几种动物，特别是家猪、野猪和野生鹿是HEV-3和HEV-4基因型的储存宿主。人类通过摄入受感染动物的生肉或未煮熟的肉以及用这些肝脏制成并在超市出售的猪肝或香肠而感染。HEV可通过输血和血液成分输血传播，目前正在认真考虑对献血者进行HEV筛查。器官移植患者中已出现导致快速进展性肝硬化和终末期肝病的慢性戊型肝炎。利巴韦林单药治疗在大多数患者中可实现持续病毒学应答。HEV 239疫苗已在中国上市，并报告了其超过四年半的长期疗效。
