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.
Liver Int. 2021 Jun;41 Suppl 1:68-72. doi: 10.1111/liv.14880. Epub 2021 May 11.
Hepatitis E virus (HEV) infection is a worldwide disease and the primary cause of acute viral hepatitis with an estimated 3.3 million symptomatic cases every year and 44,000 related deaths. It 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 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. HEV can also cause neurological disorders and chronic infections in immunocompromised patients. The progression of acute hepatitis E is usually asymptomatic and resolves spontaneously. Diagnosis is based on both anti-HEV IgM antibodies in serum and viral RNA detection in blood or stools by PCR in immunocompetent patients, while only PCR is validated in immunocompromised individuals. Ribavirin is the only validated treatment in chronic infection. A vaccine has been developed in China.
戊型肝炎病毒（HEV）感染是一种全球性疾病，是导致急性病毒性肝炎的主要原因，每年估计有 330 万例有症状病例和 4.4 万相关死亡病例。戊肝是发展中国家的一种水源性传染病。在这些国家，HEV 基因型 1 和 2 引起大规模暴发，影响年轻人群，导致孕妇和肝硬化患者的死亡率显著升高。在发达国家，HEV 基因型 3 和 4 导致本地散发性肝炎，传播途径为动物源性。血液制品输注引起的血源性传播已被确定为一种新的潜在传播方式。HEV 还可引起免疫功能低下患者的神经紊乱和慢性感染。急性戊型肝炎的进展通常无症状，可自行消退。诊断依据是血清中抗 HEV IgM 抗体和免疫功能正常患者血液或粪便中病毒 RNA 的 PCR 检测，而免疫功能低下个体仅验证了 PCR。利巴韦林是慢性感染的唯一有效治疗药物。中国已开发出一种疫苗。
