Nanda S K, Ansari I H, Acharya S K, Jameel S, Panda S K
Department of Pathology, All India Institute of Medical Sciences, New Delhi.
Gastroenterology. 1995 Jan;108(1):225-30. doi: 10.1016/0016-5085(95)90028-4.
BACKGROUND/AIMS: Hepatitis E virus (HEV) is associated with epidemic and sporadic hepatitis in developing countries. The disease is largely self-limited with no long-term sequelae. The source of HEV for maintenance of the disease in an endemic area is unknown. This study investigated the occurrence and duration of viremia in patients with acute sporadic HEV infection.
In 26 of 37 patients with sporadic acute non-A, non-B viral hepatitis, HEV infection was diagnosed based on positivity for immunoglobulin M anti-HEV and/or presence of viremia as shown by reverse-transcription polymerase chain reaction. In 4 patients, fecal samples were analyzed for presence of virus using polymerase chain reaction. Multiple samples were studied at varying times in 20 patients.
Viremia was detected in 19 of 26 patients. Two patients had viremia in the absence of immunoglobulin M anti-HEV. Four patients had protracted viremia of 45-112 days' duration. One patient showed fecal virus shedding up to the 52nd day of illness.
Protracted viremia and prolonged fecal shedding of HEV were shown in a small group of patients. These patients may serve as temporary virus carriers responsible for continuous contamination of the sewage water.
背景/目的：戊型肝炎病毒（HEV）与发展中国家的流行性和散发性肝炎相关。该疾病大多为自限性，无长期后遗症。在地方性流行地区维持该疾病的HEV来源尚不清楚。本研究调查了急性散发性HEV感染患者病毒血症的发生情况和持续时间。
在37例散发性急性非甲非乙型病毒性肝炎患者中的26例中，基于抗HEV免疫球蛋白M阳性和/或逆转录聚合酶链反应显示的病毒血症确诊为HEV感染。对4例患者的粪便样本进行聚合酶链反应分析以检测病毒的存在。对20例患者在不同时间研究多个样本。
26例患者中的19例检测到病毒血症。2例患者在没有抗HEV免疫球蛋白M的情况下出现病毒血症。4例患者有持续45 - 112天的持续性病毒血症。1例患者在疾病第52天仍有粪便病毒排出。
一小部分患者出现了持续性病毒血症和HEV粪便排泄延长。这些患者可能作为临时病毒携带者，导致污水持续污染。
