Department of Biology, College of Science, University of Bahrain, Sakhir 32038, Bahrain.
The National Center for Disease Prevention and Control, Jazan 82722-2476, Saudi Arabia.
Medicina (Kaunas). 2020 Apr 25;56(5):206. doi: 10.3390/medicina56050206.
Hepatitis E Virus (HEV) is emerging as the primary cause of acute viral hepatitis in humans. The virus is commonly transmitted by the fecal-oral route via contaminated water in endemic regions or through the consumption of inadequately cooked swine products or game meats in industrialized regions. HEV genotypes 1 and 2 are predominantly associated with waterborne transmission in developing countries, whereas and are mainly zoonotically transmitted in industrialized countries. Seroprevalence in populations determined by detecting anti-HEV antibodies and serum HEV RNA is commonly used to analyze the presence of HEV. Although HEV RNA-based detection is now standardized, there is a lack of agreement between the assaying methods used for gathering seroprevalence data. Since 2004, HEV has been considered as a transmissible infectious agent through blood transfusion. Recent seroprevalence studies in European countries indicate an underestimated risk for blood transfusion and hence warrant testing the blood supply. HEV infection is usually self-limiting and spontaneously cleared. However, in about 60% of recipients of solid organ transplants, HEV progresses to chronic hepatitis. Immunosuppressive drugs such as tacrolimus are a major cause of chronic hepatitis and reducing its dosage results in viral clearance in about 30% of patients. In hemodialysis patients, the parenteral route is implicated as an important mechanism of transmission. In this review, we explore the clinical and epidemiological characteristics of various HEV genotypes in blood donors, hemodialysis patients, and transplant recipients.
戊型肝炎病毒（HEV）正在成为人类急性病毒性肝炎的主要病因。该病毒通常通过粪-口途径传播，在流行地区通过污染的水传播，或在工业化地区通过食用未充分煮熟的猪产品或野味传播。基因型 1 和 2 主要与发展中国家的水源性传播有关，而 和 主要在工业化国家通过动物传播。通过检测抗-HEV 抗体和血清 HEV RNA 来确定人群中的血清阳性率，通常用于分析 HEV 的存在。虽然基于 HEV RNA 的检测现在已经标准化，但用于收集血清阳性率数据的检测方法之间缺乏一致性。自 2004 年以来，HEV 已被认为是一种通过输血传播的传染性病原体。最近在欧洲国家进行的血清阳性率研究表明，输血存在被低估的风险，因此需要对血液供应进行检测。HEV 感染通常是自限性的，会自行清除。然而，在大约 60%的实体器官移植受者中，HEV 进展为慢性肝炎。免疫抑制剂如他克莫司是慢性肝炎的主要原因，减少其剂量可使大约 30%的患者清除病毒。在血液透析患者中，静脉途径被认为是重要的传播机制。在这篇综述中，我们探讨了血液供者、血液透析患者和移植受者中各种 HEV 基因型的临床和流行病学特征。
