Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, Baltimore, Maryland.
Division of Gastroenterology & Hepatology, University of Maryland, Baltimore, Maryland.
J Viral Hepat. 2019 Apr;26(4):414-421. doi: 10.1111/jvh.13059. Epub 2019 Feb 5.
Hepatitis E virus (HEV) has traditionally been associated with an acute, self-limiting hepatitis and is not known to have any chronic sequelae. HEV genotypes 1 and 2, which are human pathogens, have been associated with this self-limiting presentation, in both sporadic and epidemic settings. HEV genotype 3, which is zoonotically transmitted, is increasingly being reported as a cause of chronic infection in immunocompromised patients. These include patients with solid organ transplants, patients receiving chemotherapy for haematologic malignancies and patients infected with HIV. Chronic infection is associated with rapidly progressing liver disease and extrahepatic manifestations including neurologic disorders. We review the clinical manifestations of chronic HEV infection and discuss factors determining persistence and chronicity of HEV.
戊型肝炎病毒（HEV）通常与急性、自限性肝炎相关，并无已知慢性后遗症。HEV 基因型 1 和 2 是人病原体，与这种自限性表现相关，无论是散发性还是流行环境。通过动物传播的 HEV 基因型 3，在免疫功能低下的患者中越来越多地被报告为慢性感染的原因。这些患者包括实体器官移植患者、接受血液恶性肿瘤化疗的患者和感染 HIV 的患者。慢性感染与迅速进展的肝病和肝外表现有关，包括神经障碍。我们综述慢性 HEV 感染的临床表现，并讨论决定 HEV 持续存在和慢性化的因素。
