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戊型肝炎病毒严重感染的发病机制及临床特征

Pathogenesis and clinical features of severe hepatitis E virus infection.

作者信息

Orosz László, Sárvári Károly Péter, Dernovics Áron, Rosztóczy András, Megyeri Klára

机构信息

Department of Medical Microbiology, University of Szeged, Szeged 6720, Csongrád-Csanád, Hungary.

Department of Internal Medicine, Division of Gastroenterology, University of Szeged, Szeged 6725, Csongrád-Csanád, Hungary.

出版信息

World J Virol. 2024 Jun 25;13(2):91580. doi: 10.5501/wjv.v13.i2.91580.

Abstract

The hepatitis E virus (HEV), a member of the family, is a small, non-enveloped icosahedral virus divided into eight distinct genotypes (HEV-1 to HEV-8). Only genotypes 1 to 4 are known to cause diseases in humans. Genotypes 1 and 2 commonly spread fecal-oral transmission, often through the consumption of contaminated water. Genotypes 3 and 4 are known to infect pigs, deer, and wild boars, often transferring to humans through inadequately cooked meat. Acute hepatitis caused by HEV in healthy individuals is mostly asymptomatic or associated with minor symptoms, such as jaundice. However, in immunosuppressed individuals, the disease can progress to chronic hepatitis and even escalate to cirrhosis. For pregnant women, an HEV infection can cause fulminant liver failure, with a potential mortality rate of 25%. Mortality rates also rise amongst cirrhotic patients when they contract an acute HEV infection, which can even trigger acute-on-chronic liver failure if layered onto pre-existing chronic liver disease. As the prevalence of HEV infection continues to rise worldwide, highlighting the particular risks associated with severe HEV infection is of major medical interest. This text offers a brief summary of the characteristics of hepatitis developed by patient groups at an elevated risk of severe HEV infection.

摘要

戊型肝炎病毒(HEV)是该病毒家族的成员之一,是一种小型、无包膜的二十面体病毒,分为八个不同的基因型(HEV-1至HEV-8)。已知只有基因型1至4会导致人类疾病。基因型1和2通常通过粪-口传播,常因饮用受污染的水而传播。已知基因型3和4会感染猪、鹿和野猪,常通过食用未煮熟的肉类传播给人类。健康个体中由HEV引起的急性肝炎大多无症状或伴有轻微症状,如黄疸。然而,在免疫抑制个体中,疾病可能进展为慢性肝炎,甚至发展为肝硬化。对于孕妇,HEV感染可导致暴发性肝衰竭,潜在死亡率为25%。肝硬化患者感染急性HEV时死亡率也会上升,如果叠加在已有的慢性肝病之上,甚至可能引发慢加急性肝衰竭。随着全球HEV感染患病率持续上升,突出与严重HEV感染相关的特定风险具有重大医学意义。本文简要总结了严重HEV感染风险较高的患者群体所患肝炎的特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be62/11229844/d65e96afbf51/91580-g001.jpg

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