Abstract：
Hepatitis E virus (HEV) exhibits tropism toward hepatocytes and thus affects the liver; however, HEV may also affect other tissues, including the heart, kidneys, intestines, testicles, and central nervous system. To date, the pathophysiological links between HEV infection and extrahepatic manifestations have not yet been established. Considering that HEV infects multiple types of cells, the direct effects of virus replication in peripheral tissues represent a plausible explanation for extrahepatic manifestations. In addition, since the immune response is crucial in the development of the disease, the immune characteristics of affected tissues should be revisited to identify commonalities explaining the effects of the virus. This review summarizes the most recent advances in understanding the virus biology and immune-privileged status of specific tissues as major elements for HEV replication in diverse organs. These discoveries may open avenues to explain the multiple extrahepatic manifestations associated with HEV infection and ultimately to design effective strategies for infection control.
摘要：
戊型肝炎病毒（HEV）表现出对肝细胞的嗜性，从而影响肝脏；然而，HEV也可能影响其他组织，包括心脏,肾脏，肠子,睾丸,和中枢神经系统。迄今为止,HEV感染与肝外表现之间的病理生理联系尚未确定.考虑到HEV感染多种类型的细胞，病毒在外周组织复制的直接作用为肝外表现提供了合理的解释.此外,由于免疫反应在疾病的发展中至关重要，应重新审视受影响组织的免疫特征，以确定解释病毒作用的共性。这篇综述总结了在理解病毒生物学和特定组织作为HEV在不同器官中复制的主要元件的免疫特权状态方面的最新进展。这些发现可能为解释与HEV感染相关的多种肝外表现并最终设计有效的感染控制策略开辟了道路。
