Kamani Lubna, Padhani Zahra Ali, Das Jai K
Associate Professor & Director, GI Residency Program, Department of Gastroenterology Liaquat National Hospital and Medical College Karachi Pakistan.
Consultant Aga Khan University Hospital Karachi Pakistan.
JGH Open. 2021 Aug 30;5(10):1127-1134. doi: 10.1002/jgh3.12646. eCollection 2021 Oct.
Hepatitis E virus (HEV) is considered an emergent source of viral hepatitis worldwide, with an increasing burden of jaundice, liver failure, extrahepatic illnesses, and deaths in developed countries. With the scarcity of data from efficient animal models, there are still open-ended questions about designing new models to study pathogenesis, types, virology, and evolution of these viruses. With an emphasis on available data and updates, there is still enough information to understand the HEV life cycle, pathogen interaction with the host, and the valuation of the role of vaccine and new anti-HEV therapies. However, the World Health Organization (WHO) and the European Association for the Study of the Liver (EASL) preferred to stress prevention and control measures of HEV infections in animals, zoonotic transmission, and foodborne transmission. It is being reviewed that with current knowledge on HEV and existing prevention tools, there is an excellent room for in-depth information about the virus strains, their replication, pathogenicity, and virulence. The current knowledge set also has gaps regarding standardized and validated diagnostic tools, efficacy and safety of the vaccine, and extrahepatic manifestations specifically in pregnant females, immunocompromised patients, and others. This review highlights the areas for more research exploration, focusing on enlisted research questions based on HEV infection to endorse the need for significant improvement in the current set of knowledge for this public health problem.
戊型肝炎病毒（HEV）被认为是全球病毒性肝炎的一个新出现的来源，在发达国家，黄疸、肝衰竭、肝外疾病和死亡的负担日益加重。由于缺乏来自有效动物模型的数据，关于设计新模型来研究这些病毒的发病机制、类型、病毒学和进化，仍然存在一些悬而未决的问题。尽管重点关注现有数据和更新情况，但仍有足够的信息来了解HEV的生命周期、病原体与宿主的相互作用，以及疫苗和新型抗HEV疗法的作用评估。然而，世界卫生组织（WHO）和欧洲肝脏研究协会（EASL）更倾向于强调动物中HEV感染、人畜共患病传播和食源性传播的预防和控制措施。据审查，基于目前对HEV的了解和现有的预防工具，在病毒株、其复制、致病性和毒力方面仍有很大的深入研究空间。目前的知识体系在标准化和经过验证的诊断工具、疫苗的有效性和安全性，以及特别是在孕妇、免疫功能低下患者和其他人群中的肝外表现方面也存在差距。本综述强调了需要更多研究探索的领域，重点关注基于HEV感染列出的研究问题，以认可针对这一公共卫生问题显著改进现有知识体系的必要性。
