Marion Olivier, Izopet Jacques, Kamar Nassim
Département de néphrologie et transplantation d'organes, hôpital Rangueil. Inserm UMR1043, centre de physiopathologie de Toulouse-Purpan.
Centre national de référence Hépatite E, laboratoire de virologie, hôpital Purpan. Inserm UMR1043, centre de physiopathologie de Toulouse-Purpan. Université Toulouse-III Paul-Sabatier CHU de Toulouse, Toulouse, France.
Rev Prat. 2018 Mar;68(3):286-290.
Hepatitis E virus infection. Hepatitis E virus (HEV) infection is currently recognized as an endemic pathogen in developed countries, especially in Western Europe. In these regions, HEV is a zoonotic agent and is mainly transmitted by the consumption of under cooked pig or game meat. HEV infection is generally a self-limiting illness in immunocompetent subjects. Conversely, in immunocompromised patients, i.e., solid-organ-transplant recipients, human immunodeficiency virus-infected patients with a low CD4 cell count, hematological patients receiving chemotherapy, and patients given immune suppressive therapy, HEV can lead to chronic hepatitis and cirrhosis. In this case, if viral replication persists despite immunosuppressive regimen decrease, ribavirin therapy has to be initiated to allow viral clearance. Recently, some extra-hepatic manifestations associated with HEV infection have been observed, suggesting a broader tropism than initially considered.
戊型肝炎病毒感染。戊型肝炎病毒（HEV）感染目前在发达国家被认为是一种地方性病原体，尤其是在西欧。在这些地区，HEV是一种人畜共患病原体，主要通过食用未煮熟的猪肉或野味传播。在免疫功能正常的个体中，HEV感染通常是一种自限性疾病。相反，在免疫功能低下的患者中，即实体器官移植受者、CD4细胞计数低的人类免疫缺陷病毒感染患者、接受化疗的血液病患者以及接受免疫抑制治疗的患者中，HEV可导致慢性肝炎和肝硬化。在这种情况下，如果尽管免疫抑制方案减少但病毒复制仍持续存在，则必须启动利巴韦林治疗以清除病毒。最近，已观察到一些与HEV感染相关的肝外表现，这表明其嗜性比最初认为的更广泛。
