State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, School of Life Sciences, Xiamen University, Xiamen, China.
Department of Infectious Disease, Xiang'an Hospital of Xiamen University, Xiamen, China.
Front Immunol. 2023 Jun 19;14:1183859. doi: 10.3389/fimmu.2023.1183859. eCollection 2023.
Chronic hepatitis E virus (HEV) infection occurs mainly in immunosuppressed populations. We describe an investigation of chronic HEV infection of genotype 3a in an individual without evidence for immune deficiency who presented hepatitis with significant HEV viremia and viral shedding. We monitored HEV RNA in plasma and stools, and assessed anti-HEV specific immune responses. The patient was without apparent immunodeficiency based on quantified results of white blood cell, lymphocyte, neutrophilic granulocyte, CD3+ T cell, CD4+ T cell, and CD8+ T cell counts and CD4/CD8 ratio, as well as total serum IgG, IgM, and IgA, which were in the normal range. Despite HEV specific cellular response and strong humoral immunity being observed, viral shedding persisted up to 10 IU/mL. After treatment with ribavirin combined with interferon, the indicators of liver function in the patient returned to normal, accompanied by complete suppression and clearance of HEV. These results indicate that HEV chronicity can also occur in individuals without evidence of immunodeficiency.
慢性戊型肝炎病毒（HEV）感染主要发生在免疫抑制人群中。我们描述了一例基因型 3a 的慢性 HEV 感染的调查，该患者无免疫缺陷证据，但表现为肝炎，伴有明显的 HEV 病毒血症和病毒脱落。我们监测了血浆和粪便中的 HEV RNA，并评估了抗-HEV 特异性免疫反应。该患者的白细胞、淋巴细胞、中性粒细胞、CD3+T 细胞、CD4+T 细胞、CD8+T 细胞计数和 CD4/CD8 比值以及总血清 IgG、IgM 和 IgA 的定量结果均正常，无明显免疫缺陷。尽管观察到 HEV 特异性细胞反应和强烈的体液免疫，但病毒脱落持续至 10 IU/mL。用利巴韦林联合干扰素治疗后，患者肝功能指标恢复正常，同时完全抑制和清除了 HEV。这些结果表明，无免疫缺陷证据的个体也可能发生 HEV 慢性感染。
