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Abstract：
Hepatitis E Virus (HEV) is emerging as the primary cause of acute viral hepatitis in humans. The virus is commonly transmitted by the fecal-oral route via contaminated water in endemic regions or through the consumption of inadequately cooked swine products or game meats in industrialized regions. HEV genotypes 1 and 2 are predominantly associated with waterborne transmission in developing countries, whereas HEV3 and HEV4 are mainly zoonotically transmitted in industrialized countries. Seroprevalence in populations determined by detecting anti-HEV antibodies and serum HEV RNA is commonly used to analyze the presence of HEV. Although HEV RNA-based detection is now standardized, there is a lack of agreement between the assaying methods used for gathering seroprevalence data. Since 2004, HEV has been considered as a transmissible infectious agent through blood transfusion. Recent seroprevalence studies in European countries indicate an underestimated risk for blood transfusion and hence warrant testing the blood supply. HEV infection is usually self-limiting and spontaneously cleared. However, in about 60% of recipients of solid organ transplants, HEV progresses to chronic hepatitis. Immunosuppressive drugs such as tacrolimus are a major cause of chronic hepatitis and reducing its dosage results in viral clearance in about 30% of patients. In hemodialysis patients, the parenteral route is implicated as an important mechanism of transmission. In this review, we explore the clinical and epidemiological characteristics of various HEV genotypes in blood donors, hemodialysis patients, and transplant recipients.
摘要：
戊型肝炎病毒（HEV）正在成为人类急性病毒性肝炎的主要原因。该病毒通常通过粪便-口腔途径通过在流行地区的污染水或通过在工业化地区食用未充分煮熟的猪产品或野味肉传播。在发展中国家，HEV基因型1和2主要与水媒传播有关。而HEV3和HEV4主要在工业化国家以人畜共传播。通过检测抗HEV抗体和血清HEVRNA确定的群体中的血清阳性率通常用于分析HEV的存在。尽管HEV基于RNA的检测现在已经标准化，用于收集血清阳性率数据的分析方法之间缺乏共识。自2004年以来，HEV一直被认为是通过输血传播的传染性病原体。欧洲国家最近的血清阳性率研究表明，输血的风险被低估，因此需要测试血液供应。HEV感染通常是自限性和自发清除的。然而,在大约60%的实体器官移植接受者中，HEV进展为慢性肝炎。免疫抑制药物如他克莫司是慢性肝炎的主要原因,并且减少其剂量导致约30%的患者的病毒清除。在血液透析患者中，肠胃外途径被认为是一种重要的传播机制。在这次审查中,我们探讨了献血者中各种HEV基因型的临床和流行病学特征，血液透析患者，和移植接受者。
