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戊型肝炎,真正的问题是什么?

Hepatitis E, what's the real issue?

作者信息

Larrue Hélène, Abravanel Florence, Péron Jean-Marie

机构信息

Service d'hépatologie Hôpital Rangueil CHU Toulouse, Université Paul Sabatier III, Toulouse, France.

Laboratoire de Virologie Hôpital Purpan CHU Toulouse, Université Paul Sabatier III, Toulouse, France.

出版信息

Liver Int. 2020 Feb;40 Suppl 1:43-47. doi: 10.1111/liv.14351.

Abstract

Hepatitis E Virus (HEV) infection is a worldwide disease and the primary cause of acute viral hepatitis in the world with an estimated 20 million cases every year and 70 000 deaths. Hepatitis E is a waterborne infection in the developing countries. In these countries, HEV genotypes 1 and 2 cause large outbreaks and affect young subjects, resulting in significant mortality in pregnant women and patients with cirrhosis. In the developed countries, HEV genotypes 3 and 4 are responsible for autochthonous, sporadic hepatitis and transmission is zoonotic. Parenteral transmission by the transfusion of blood products has been identified as a potential new mode of transmission. The prevalence of positive HEV viraemia in blood donors in Europe ranges from 1/600 to 1/2500 in highly endemic European countries. HEV can cause neurological disorders and chronic infections in immunocompromised patients. The progression of acute hepatitis E is usually asymptomatic and resolves spontaneously. Diagnostic tools include anti-HEV IgM antibodies in serum and/or viral RNA detection in the blood or the stools by PCR. Ribavirin is used to treat chronic infection. A vaccine has been developed in China.

摘要

戊型肝炎病毒(HEV)感染是一种全球性疾病,是全球急性病毒性肝炎的主要病因,估计每年有2000万例病例,7万人死亡。在发展中国家,戊型肝炎是一种经水传播的感染性疾病。在这些国家,1型和2型戊型肝炎病毒会引发大规模疫情,并影响年轻人群,导致孕妇和肝硬化患者出现显著死亡率。在发达国家,3型和4型戊型肝炎病毒是散发性肝炎的病因,传播途径为人畜共患病。通过输血进行的肠道外传播已被确认为一种潜在的新传播方式。在欧洲高流行国家,献血者中戊型肝炎病毒血症阳性的患病率在1/600至1/2500之间。戊型肝炎病毒可导致免疫功能低下患者出现神经功能障碍和慢性感染。急性戊型肝炎的病程通常无症状,并可自发缓解。诊断工具包括血清中的抗戊型肝炎病毒IgM抗体和/或通过聚合酶链反应检测血液或粪便中的病毒RNA。利巴韦林用于治疗慢性感染。中国已研发出一种疫苗。

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