PDF(Pubmed)
Abstract：
Hepatitis E virus (HEV) is an important cause of acute hepatitis, however, is highly neglected and largely underreported. This study aimed to describe the detailed epidemiology of hepatitis E (HE) through a 10-year surveillance. A community-based active hepatitis surveillance was conducted between November 2007 and October 2017 in 11 townships of Dongtai City in China, involving 355,673 residents. Serum samples were obtained from patients presenting with hepatitis symptoms for more than 3 days. Serum alanine aminotransferase (ALT) levels greater than 2.5 times the upper limit of normal (ULN) were considered acute hepatitis. Samples were subsequently tested for IgG and IgM anti-HEV antibodies, HEV RNA, and hepatitis B surface antigen (HBsAg). The data indicated the incidence of HE fluctuated downward from 2007 to 2017, with an average annual age-standardized incidence of 17.50 per 100,000, exceeding the 10.26 per 100,000 in the National Notifiable Disease Report System (NNDRS). The incidence was notably higher among males (20.95 per 100,000) and individuals aged 50-69 years (37.47 per 100,000). Genotype 4 (HEV-4) was the predominantly circulating genotype during the study period. Furthermore, the study revealed the incidence of hepatitis with HEV and hepatitis B virus (HBV) co-infection was 4.99 per 100,000. The active surveillance system identified a higher incidence of HE compared to NNDRS, with a decreased prevalence over a 10-year period. While efforts are still needed to prevent HE in high-risk populations, including individuals with hepatitis B and the elderly.
摘要：
背景戊型肝炎病毒(HEV)是急性肝炎的重要病因,然而,被高度忽视和大量低估。这项研究旨在通过10年的监测来描述戊型肝炎（HE）的详细流行病学。方法2007年11月至2017年10月，在中国东台市11个乡镇进行基于社区的活动性肝炎监测，涉及355,673名居民。从表现出肝炎症状超过3天的患者获得血清样品。血清丙氨酸转氨酶（ALT）水平高于正常上限（ULN）的2.5倍被认为是急性肝炎。随后测试样品的IgG和IgM抗HEV抗体，HEVRNA,和乙型肝炎表面抗原（HBsAg）。结果2007-2017年HE发病率呈波动趋势,年均年龄标准化发病率为17.50/10,超过国家法定疾病报告系统(NNDRS)10.26/10。男性（20.95/100,000）和50-69岁的个体（37.47/100,000）的发病率明显更高。基因型4(HEV-4)是研究期间主要的循环基因型。此外，研究显示,肝炎合并HEV和乙型肝炎病毒(HBV)共感染的发病率为4.99/100,000.结论主动监测系统发现HE的发生率高于NNDRS，在10年内患病率下降。虽然仍需要努力在高危人群中预防HE，包括乙型肝炎患者和老年人。
