Department of Molecular Biology, Princeton University, Lewis Thomas Laboratory, Washington Road, Princeton, New Jersey 08544, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Weill Medical College of Cornell University, New York, New York 10021, USA.
Nat Rev Gastroenterol Hepatol. 2018 Feb;15(2):96-110. doi: 10.1038/nrgastro.2017.150. Epub 2017 Nov 22.
At least 20 million hepatitis E virus (HEV) infections occur annually, with >3 million symptomatic cases and ∼60,000 fatalities. Hepatitis E is generally self-limiting, with a case fatality rate of 0.5-3% in young adults. However, it can cause up to 30% mortality in pregnant women in the third trimester and can become chronic in immunocompromised individuals, such as those receiving organ transplants or chemotherapy and individuals with HIV infection. HEV is transmitted primarily via the faecal-oral route and was previously thought to be a public health concern only in developing countries. It is now also being frequently reported in industrialized countries, where it is transmitted zoonotically or through organ transplantation or blood transfusions. Although a vaccine for HEV has been developed, it is only licensed in China. Additionally, no effective, non-teratogenic and specific treatments against HEV infections are currently available. Although progress has been made in characterizing HEV biology, the scarcity of adequate experimental platforms has hampered further research. In this Review, we focus on providing an update on the HEV life cycle. We will further discuss existing cell culture and animal models and highlight platforms that have proven to be useful and/or are emerging for studying other hepatotropic (viral) pathogens.
每年至少有 2000 万人感染戊型肝炎病毒 (HEV)，其中超过 300 万人出现症状，约 6 万人死亡。戊型肝炎通常是自限性的，在年轻成年人中的病死率为 0.5-3%。然而，它可导致妊娠晚期的孕妇高达 30%的死亡率，并可在免疫功能低下的个体中成为慢性疾病，如接受器官移植或化疗的个体以及感染 HIV 的个体。HEV 主要通过粪-口途径传播，以前被认为仅在发展中国家是一个公共卫生问题。现在它也在工业化国家频繁报告，在这些国家中，它通过动物传播或通过器官移植或输血传播。虽然已经开发出针对 HEV 的疫苗，但它仅在中国获得许可。此外，目前尚无针对 HEV 感染的有效、非致畸和特异性治疗方法。尽管在描述 HEV 生物学方面已经取得了进展，但缺乏足够的实验平台阻碍了进一步的研究。在这篇综述中，我们重点介绍 HEV 生命周期的最新进展。我们将进一步讨论现有的细胞培养和动物模型，并强调已经证明有用和/或正在出现的用于研究其他嗜肝（病毒）病原体的平台。
