Lee Ga Young, Poovorawan Kittiyod, Intharasongkroh Duangnapa, Sa-Nguanmoo Pattaratida, Vongpunsawad Sompong, Chirathaworn Chintana, Poovorawan Yong
Ga Young Lee, Kittiyod Poovorawan, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
World J Virol. 2015 Nov 12;4(4):343-55. doi: 10.5501/wjv.v4.i4.343.
Hepatitis E virus (HEV) infection is now established as an emerging enteric viral hepatitis. Standard treatments in acute and chronic hepatitis E remain to be established. This study undertakes a review of the epidemiology, treatment implication and vaccine prevention from published literature. HEV infection is a worldwide public health problem and can cause acute and chronic hepatitis E. HEV genotypes 1 and 2 are primarily found in developing countries due to waterborne transmission, while the zoonotic potential of genotypes 3 and 4 affects mostly industrialized countries. An awareness of HEV transmission through blood donation, especially in the immunocompromised and solid organ transplant patients, merits an effective anti-viral therapy. There are currently no clear indications for the treatment of acute hepatitis E. Despite concerns for side effects, ribavirin monotherapy or in combination with pegylated interferon alpha for at least 3 mo appeared to show significant efficacy in the treatment of chronic hepatitis E. However, there are no available treatment options for specific patient population groups, such as women who are pregnant. Vaccination and screening of HEV in blood donors are currently a global priority in managing infection. New strategies for the treatment and control of hepatitis E are required for both acute and chronic infections, such as prophylactic use of medications, controlling large outbreaks, and finding acceptable antiviral therapy for pregnant women and other patient groups for whom the current options of treatment are not viable.
戊型肝炎病毒（HEV）感染现已被确认为一种新出现的肠道病毒性肝炎。急性和慢性戊型肝炎的标准治疗方法仍有待确定。本研究对已发表文献中的流行病学、治疗意义及疫苗预防进行了综述。戊型肝炎病毒感染是一个全球性的公共卫生问题，可导致急性和慢性戊型肝炎。由于水源性传播，1型和2型戊型肝炎病毒主要在发展中国家被发现，而3型和4型戊型肝炎病毒的人畜共患潜力主要影响工业化国家。认识到戊型肝炎病毒通过献血传播，尤其是在免疫功能低下和实体器官移植患者中，这就需要一种有效的抗病毒治疗方法。目前，急性戊型肝炎的治疗尚无明确指征。尽管存在副作用方面的担忧，但利巴韦林单药治疗或与聚乙二醇化干扰素α联合使用至少3个月，似乎在慢性戊型肝炎的治疗中显示出显著疗效。然而，对于特定患者群体，如孕妇，尚无可用的治疗选择。目前，在管理感染方面，对献血者进行戊型肝炎病毒疫苗接种和筛查是全球优先事项。对于急性和慢性感染，都需要新的戊型肝炎治疗和控制策略，如预防性使用药物、控制大规模疫情，以及为孕妇和其他目前治疗选择不可行的患者群体找到可接受的抗病毒治疗方法。
