Shrestha Ananta
Department of Hepatology, The Liver Clinic, Liver Foundation Nepal, Tripureshwor, Kathmandu, Nepal.
Euroasian J Hepatogastroenterol. 2015 Jan-Jun;5(1):40-42. doi: 10.5005/jp-journals-10018-1128. Epub 2015 Jan 6.
Geographical and ethnic diversity in Nepal has led to interesting epidemiology of viral hepatitis and liver diseases. Before the epidemic of Biratnagar that occurred in April to June 2014, Kathmandu was the only known endemic region for hepatitis E virus infection (HEV), where at least four previous epidemics have been documented since 1973. Due to rapid urbanization with still low socioeconomic condition, other major cities are appreciated to be at increasing risk of outbreaks. Characteristics of HEV epidemics and genetic changes of HEV during last decade have been studied. While hepatitis A virus infection was only common during childhood till recent years, it is re-emerging as an important etiology of acute hepatitis in young adults. Nepal is classified as low endemic region for hepatitis B virus infection (HBV) with overall seroprevalence of 1.1%. But, some ethnic groups and geographical areas have high prevalence rates. Despite low endemicity, HBV accounts for majority of cases of hepatocellular carcinoma and liver cirrhosis in the country. Similarly, though hepatitis C virus (HCV) is present in only 0.4% of general population, high seroprevalence was found among intravenous drug abusers many of them with HIV coinfection. Apart from hepatitis viruses, alcohol use also contributes significantly to liver cirrhosis and chronic liver failure. A unique form of hepatic venous outflow obstruction called 'hepatic vena cava syndrome' has been identified as an important etiology of liver cirrhosis and hepatocellular carcinoma.
Shrestha A. Epidemiology of Viral Hepatitis and Liver Diseases in Nepal. Euroasian J Hepato-Gastroenterol 2015;5(1):40-42.
尼泊尔的地理和种族多样性导致了病毒性肝炎和肝脏疾病有趣的流行病学情况。在2014年4月至6月发生的比拉特纳加疫情之前，加德满都是已知的戊型肝炎病毒感染（HEV）唯一流行地区，自1973年以来至少记录了四次疫情。由于快速城市化且社会经济状况仍然较低，其他主要城市被认为爆发风险在增加。过去十年中戊型肝炎疫情特征及戊型肝炎病毒的基因变化已得到研究。虽然甲型肝炎病毒感染直到近年来在儿童时期才常见，但它正重新成为年轻成年人急性肝炎的重要病因。尼泊尔被归类为乙型肝炎病毒感染（HBV）低流行地区，总体血清流行率为1.1%。但是，一些种族群体和地理区域患病率较高。尽管流行率较低，但HBV占该国肝细胞癌和肝硬化病例的大多数。同样，虽然丙型肝炎病毒（HCV）仅在0.4%的普通人群中存在，但在静脉吸毒者中发现了高血清流行率，其中许多人同时感染了HIV。除了肝炎病毒外，饮酒也对肝硬化和慢性肝衰竭有显著影响。一种称为“肝静脉阻塞综合征”的独特肝静脉流出道梗阻形式已被确定为肝硬化和肝细胞癌的重要病因。
什雷斯塔A。尼泊尔病毒性肝炎和肝脏疾病的流行病学。《欧亚肝脏胃肠病学杂志》2015年；5(1):40 - 42。
