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戊型病毒性肝炎与慢性化:日益受到关注的公共卫生问题

Viral Hepatitis E and Chronicity: A Growing Public Health Concern.

作者信息

Thakur Vikram, Ratho Radha Kanta, Kumar Swatantra, Saxena Shailendra K, Bora Ishani, Thakur Pryanka

机构信息

Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India.

出版信息

Front Microbiol. 2020 Sep 29;11:577339. doi: 10.3389/fmicb.2020.577339. eCollection 2020.

Abstract

Hepatitis E viral infection recently emerges as a global health concern. Over the last decade, the understanding of hepatitis E virus (HEV) had changed with the discovery of new genotypes like genotype-7 and genotype-8 with associated host and mode of infection. Diversification in the mode of hepatitis E infection transmission through blood transfusion, and organ transplants in contrast to classical feco-oral and zoonotic mode is the recent medical concern. The wide spectrum of infection ranging from self-limiting to acute liver failure is now overpowered by HEV genotype-specific chronic infection especially in transplant patients. This concern is further escalated by the extra-hepatic manifestations of HEV targeting the central nervous system (CNS), kidney, heart, and pancreas. However, with the development of advanced efficient cell culture systems and animal models simulating the infection, much clarity toward understanding the pathogenetic mechanism of HEV has been developed. Also this facilitates the development of vaccines research or therapeutics. In this review, we highlight all the novel findings in every aspect of HEV with special emphasis on recently emerging chronic mode of infection with specific diagnosis and treatment regime with an optimistic hope to help virologists and/or liver specialists working in the field of viral hepatitis.

摘要

戊型肝炎病毒感染最近成为全球关注的健康问题。在过去十年中,随着7型和8型等新基因型以及相关宿主和感染方式的发现,人们对戊型肝炎病毒(HEV)的认识发生了变化。与经典的粪-口传播和人畜共患病传播方式相比,戊型肝炎通过输血和器官移植传播的感染方式多样化是最近的医学关注点。从自限性感染到急性肝衰竭的广泛感染谱,现在尤其在移植患者中被HEV基因型特异性慢性感染所掩盖。HEV靶向中枢神经系统(CNS)、肾脏、心脏和胰腺的肝外表现进一步加剧了这一担忧。然而,随着先进高效细胞培养系统和模拟感染的动物模型的发展,人们对HEV致病机制的认识有了很大的清晰。这也促进了疫苗研究或治疗方法的发展。在这篇综述中,我们强调了HEV各个方面的所有新发现,特别强调了最近出现的慢性感染模式以及具体的诊断和治疗方案,怀着乐观的希望帮助从事病毒性肝炎领域工作的病毒学家和/或肝脏专家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b810/7550462/7ab2fa3df01b/fmicb-11-577339-g001.jpg

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