Nelson Kenrad E, Heaney Christopher D, Labrique Alain B, Kmush Brittany L, Krain Lisa J
aDepartment of Epidemiology bDepartment of International Health cDepartment of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Curr Opin Infect Dis. 2016 Oct;29(5):478-85. doi: 10.1097/QCO.0000000000000294.
Infection with the hepatitis E virus (HEV) is very common worldwide. The epidemiology, viral genotypes, and transmission routes differ between low-resource countries and economically developed countries. These differences have resulted in the design of diverse prevention and treatment strategies to combat HEV.
The population seroprevalence of HEV immunoglobulin G varies between 5 and 50%. However, the diagnosis of acute hepatitis from HEV has not been common in the United States or Western Europe. Chronic progressive HEV infections have been reported among patients who are immunocompromised. Successful treatment of patients with chronic hepatitis from HEV infection with antiviral agents, such as ribavirin or interferon-α, has been reported. Extrahepatic manifestations of HEV infection are common. Large epidemics of hundreds or thousands of cases continue to be reported among populations in Asia and Africa. A subunit peptide HEV vaccine has been found to be highly efficacious in a large clinical trial. However, the vaccine has not been evaluated in populations of pregnant women or other risk groups and is only available in China.
Although HEV infections are increasingly recognized as a global public health problem, there are few methods for prevention and treatment that are widely available.
戊型肝炎病毒（HEV）感染在全球非常普遍。资源匮乏国家和经济发达国家在流行病学、病毒基因型及传播途径方面存在差异。这些差异导致了对抗HEV的预防和治疗策略的多样化设计。
HEV免疫球蛋白G的人群血清阳性率在5%至50%之间。然而，在美国或西欧，由HEV引起的急性肝炎诊断并不常见。免疫功能低下患者中已报告有慢性进行性HEV感染。已报道使用抗病毒药物如利巴韦林或α干扰素成功治疗HEV感染所致慢性肝炎患者。HEV感染的肝外表现很常见。亚洲和非洲人群中仍不断有数百或数千例的大型疫情报告。一种亚单位肽HEV疫苗在大型临床试验中被发现具有高效性。然而，该疫苗尚未在孕妇或其他风险人群中进行评估，且仅在中国可用。
尽管HEV感染越来越被视为一个全球公共卫生问题，但广泛可用的预防和治疗方法却很少。
