N'Yetobouko Tabounie Stéphanie Judith, Kango Simplice Cyriaque, Bouscaillou Julie, Tricou Vianney, Fontanet Arnaud, Kazanji Mirdad, Komas Narcisse Patrice
Viral Hepatitis Laboratory, Institut Pasteur de Bangui (IPB), Bangui BP 923, Central African Republic.
Virology Department, Institut Pasteur de Bangui (IPB), Bangui BP 923, Central African Republic.
Infect Dis Rep. 2020 Nov 12;12(3):82-86. doi: 10.3390/idr12030017.
Hepatitis E virus (HEV) infection is responsible for major endemic outbreaks in developing countries. Human immunodeficiency virus (HIV) and HEV are widespread in the Central African Republic. We report the first documented case of an HEV infection in a 36-month-old child already suffering from HIV and severe acute malnutrition (SAM). The HIV patient was hospitalized for SAM with persistent diarrhea and prolonged fever. The presence of IgG anti-HEV antibodies was noted. Sequencing of the amplified HEV RNA revealed the presence of genotype 3c. The alanine aminotransferase level was slightly above average. The patient died despite being treated by antiretroviral therapy accompanied by probabilistic antibiotic therapy and nutritional rehabilitation. HEV/HIV co-infection in a malnourished patient can accelerate a fatal outcome. In the presence of biological abnormalities in a severe acutely malnourished HIV-infected patient, HEV RNA detection should be added to the standard medical assessment in sub-Saharan African countries.
戊型肝炎病毒（HEV）感染是发展中国家主要地方性疫情爆发的原因。人类免疫缺陷病毒（HIV）和HEV在中非共和国广泛传播。我们报告了首例记录在案的戊型肝炎病毒感染病例，患者为一名36个月大的儿童，已患有HIV和重度急性营养不良（SAM）。该HIV患者因SAM伴持续性腹泻和长期发热住院。检测到存在抗HEV IgG抗体。扩增的HEV RNA测序显示存在3c基因型。丙氨酸转氨酶水平略高于平均水平。尽管接受了抗逆转录病毒治疗，并伴有经验性抗生素治疗和营养康复，但患者仍死亡。营养不良患者中HEV/HIV合并感染可加速致命结局。在严重急性营养不良的HIV感染患者出现生物学异常时，撒哈拉以南非洲国家的标准医学评估中应增加HEV RNA检测。
