Institute of Clinical Medicine, University of Oslo, 0315 Oslo, Norway.
International Vaccine Institute (IVI), Seoul 08800, Republic of Korea.
Viruses. 2022 Dec 24;15(1):63. doi: 10.3390/v15010063.
HEV is the most common cause of acute hepatitis globally. This review summarizes the latest knowledge on the epidemiology, clinical characteristics, testing, and treatment of HEV infection. We also focused on Bangladesh to highlight the distinct challenges and the possible remedies. In low-income settings, the virus is mainly transmitted between people by fecal contamination of drinking water causing large outbreaks, and sporadic cases. The disease is usually mild and self-limiting acute hepatitis. Still, pregnant women and their offspring in low-income countries are at particular risk for severe disease, with up to 20% maternal mortality. Despite the high burden of the disease, HEV remains a relatively neglected virus, with detection hampered by costly tests and a lack of suitable treatments. Molecular PCR diagnostics, together with ELISA antibody tests, remain the preferred methods for diagnosis of HEV; however, rapid bedside diagnostics are available and could offer a practical alternative, especially in low-income countries. One vaccine (HEV 239) is only available in China and Pakistan, as efficacy against the other genotypes remains uncertain. The effectiveness trial conducted in Bangladesh might lead the way in gathering more efficacy data and could, together with improved surveillance and raised awareness, dramatically reduce the global burden of HEV.
戊型肝炎病毒（HEV）是全球范围内最常见的急性肝炎病因。本综述总结了 HEV 感染的最新流行病学、临床特征、检测和治疗知识。我们还重点关注了孟加拉国，以突出其独特的挑战和可能的解决办法。在低收入环境中，该病毒主要通过污染饮用水导致人与人之间的粪口传播而引起大规模暴发和散发性病例。该病通常为轻度、自限性急性肝炎。然而，低收入国家的孕妇及其婴儿特别容易患严重疾病，孕产妇死亡率高达 20%。尽管疾病负担沉重，但 HEV 仍然是一种相对被忽视的病毒，由于检测成本高昂且缺乏合适的治疗方法，其检测受到阻碍。分子 PCR 诊断与 ELISA 抗体检测仍是诊断 HEV 的首选方法；然而，快速床边诊断方法已经可用，并且可能提供一种实用的替代方法，特别是在低收入国家。只有一种疫苗（HEV 239）在中国和巴基斯坦可用，因为针对其他基因型的疗效仍不确定。在孟加拉国进行的有效性试验可能为收集更多疗效数据提供了一个途径，并且可以与改善监测和提高认识一起，大大降低全球 HEV 负担。
