Di Bartolomeo Salvatore, Carubbi Francesco, Cipriani Paola
Rheumatology Unit, Department of Biotechnological and Applied Clinical Science, School of Medicine, University of L'Aquila, L'Aquila, Italy.
Department of Medicine, ASL1 Avezzano-Sulmona-L'Aquila, L'Aquila and Sulmona, Italy.
BMC Rheumatol. 2020 Sep 21;4:51. doi: 10.1186/s41927-020-00149-0. eCollection 2020.
Hepatitis E virus (HEV) represents the most common cause of acute hepatitis and jaundice in the world. About 2 million of infection cases occur each year in Europe, mainly as autochthonous anthropozoonosis, and HEV can be transmitted through undercooked pork meat. This infection has been linked to various extra-hepatic manifestations, while chronic infections with a rapid development of liver failure have been described in heavily immunosuppressed patients undergoing solid organ transplantations (SOTs), in patients with hematological diseases or with immunodeficiency virus infection.
The purpose of this review article is to describe rheumatic manifestations related to HEV infection and their implications for rheumatologists in the daily clinical practice. Despite recent accumulating literature in this field, little is known about the course of the infection in patients with rheumatic diseases (RDs) and about the impact of immunosuppressive drugs. Moreover, HEV infection can mimic RDs' manifestations or drugs toxicity. Specific guidelines on management are lacking and the majority of data are referred to SOTs receivers.
More studies are needed to better understand the real impact of HEV infection in patients with RDs, regarding both clinical outcomes and their management.
戊型肝炎病毒（HEV）是全球急性肝炎和黄疸最常见的病因。欧洲每年约有200万例感染病例，主要为本土人兽共患病，且HEV可通过未煮熟的猪肉传播。这种感染与多种肝外表现有关，而在接受实体器官移植（SOT）的重度免疫抑制患者、血液系统疾病患者或免疫缺陷病毒感染患者中，已出现伴有快速进展性肝衰竭的慢性感染。
本文综述的目的是描述与HEV感染相关的风湿性表现及其在日常临床实践中对风湿病学家的意义。尽管该领域近期文献不断积累，但对于风湿病（RD）患者的感染病程以及免疫抑制药物的影响仍知之甚少。此外，HEV感染可模仿RD的表现或药物毒性。目前缺乏具体的管理指南，且大多数数据针对的是接受SOT者。
需要更多研究以更好地了解HEV感染对RD患者在临床结局及其管理方面的实际影响。
