Emerg Infect Dis. 2018 Dec;24(12):2241-2250. doi: 10.3201/eid2412.180937.
All hepatitis E virus (HEV) variants reported to infect humans belong to the species Orthohepevirus A (HEV-A). The zoonotic potential of the species Orthohepevirus C (HEV-C), which circulates in rats and is highly divergent from HEV-A, is unknown. We report a liver transplant recipient with hepatitis caused by HEV-C infection. We detected HEV-C RNA in multiple clinical samples and HEV-C antigen in the liver. The complete genome of the HEV-C isolate had 93.7% nt similarity to an HEV-C strain from Vietnam. The patient had preexisting HEV antibodies, which were not protective against HEV-C infection. Ribavirin was an effective treatment, resulting in resolution of hepatitis and clearance of HEV-C viremia. Testing for this zoonotic virus should be performed for immunocompromised and immunocompetent patients with unexplained hepatitis because routine hepatitis E diagnostic tests may miss HEV-C infection. HEV-C is also a potential threat to the blood product supply.
所有报告感染人类的戊型肝炎病毒 (HEV) 变体均属于正肝病毒科 A 型 (HEV-A)。在大鼠中传播且与 HEV-A 高度分化的正肝病毒科 C 型 (HEV-C) 的人畜共患病潜力尚不清楚。我们报告了一例肝移植受者因感染 HEV-C 而引起的肝炎。我们在多个临床样本中检测到 HEV-C RNA 和肝脏中的 HEV-C 抗原。HEV-C 分离株的完整基因组与来自越南的 HEV-C 株具有 93.7%的 nt 相似性。该患者先前存在 HEV 抗体，但不能预防 HEV-C 感染。利巴韦林是一种有效的治疗方法，可导致肝炎消退和 HEV-C 病毒血症清除。对于原因不明的肝炎的免疫功能低下和免疫功能正常的患者，应进行这种人畜共患病病毒的检测，因为常规的戊型肝炎诊断检测可能会漏诊 HEV-C 感染。HEV-C 也可能对血液制品供应构成威胁。
