Service d'Hépatologie, Hôpital Rangueil, CHU de Toulouse, Université Paul Sabatier Toulouse-III, France.
CHU de Toulouse, Hôpital Purpan, Laboratoire de Virologie, Centre National de Référence du Virus de L'hépatite E, Toulouse, France.
J Hepatol. 2023 Sep;79(3):876-880. doi: 10.1016/j.jhep.2023.03.024. Epub 2023 Mar 30.
Based on the worldwide distribution of hepatitis E virus (HEV) and its ability to cause major epidemics in low-income countries, the global availability of a HEV vaccine is a pressing clinical need. Populations at risk of severe forms of the infection are well characterised: patients with chronic liver disease - at risk of liver failure; pregnant women - at risk of fulminant hepatitis or obstetrical complications; and immunosuppressed patients, particularly those with solid organ transplants - at risk of chronic hepatitis and rapid progression to cirrhosis. Only one hepatitis E vaccine is presently being manufactured. It has been proven to be effective and safe. However, its accessibility, as well as data on its long-term efficacy and the duration of protection it confers, are limited. While individuals considered to be at risk of severe infection appear to be ideal targets for the vaccine, its effectiveness and tolerability have not yet been studied in populations with chronic liver disease and immunosuppressed patients. Hepatitis E vaccination could also play an important role in controlling outbreaks in large waterborne epidemics. Clinical trials on these populations are needed.
基于戊型肝炎病毒（HEV）在全球的分布及其在低收入国家引发重大疫情的能力，全球对 HEV 疫苗的需求十分迫切。具有发生严重感染风险的人群特征明确：慢性肝病患者——有发生肝衰竭的风险；孕妇——有发生暴发性肝炎或产科并发症的风险；以及免疫抑制患者，尤其是实体器官移植患者——有发生慢性肝炎和迅速进展为肝硬化的风险。目前仅有一种戊型肝炎疫苗正在生产。该疫苗已被证明是有效且安全的。然而，其可及性，以及关于其长期疗效和提供的保护持续时间的数据，均受到限制。虽然被认为有发生严重感染风险的个体似乎是疫苗的理想目标，但该疫苗在慢性肝病和免疫抑制患者人群中的有效性和耐受性尚未得到研究。戊型肝炎疫苗的接种也可能在控制大型水源性疫情爆发方面发挥重要作用。需要针对这些人群开展临床试验。
