Hepatitis E virus

Hepatitis E virus (HEV) is responsible for major outbreaks of acute hepatitis in developing countries where it was first described as a waterborne disease, transmitted by drinking water contaminated with feces. Attention was focused on HEV in developed countries and its associated diseases in recent years as a result of increasing reports of autochthonous infections. Hepatitis E is the zoonotic cause of these acute infections, and mainly in men over 50 years of age. The clinical manifestations and laboratory abnormalities of hepatitis E infections in immunocompetent patients cannot be distinguished from those caused by other hepatitis viruses. HEV is a major public health concern in immunocompromised patients because their infections can become chronic. The specific etiology of cases of hepatitis E infection can be diagnosed by serological testing and detecting viral RNA. Ribavirin is currently the reference treatment for HEV infections in immunocompromised patients. Several vaccines have proved safe and effective in clinical trials, but none have been approved for use in Europe yet.     

套式逆转录PCR检测戊型肝炎病毒RNA的临床应用

目的 评价套式逆转录PCR检测血清戊肝病毒(HEV) RNA的临床意义.方法 对GenBank数据库中的戊型肝炎病毒全基因组序列进行分析比对,并针对国内流行的HEV株序列,选择位于ORF2的保守区域设计引物,建立套式逆转录聚合酶链式反应(nRT-PCR)方法,并检测126例急性戊型肝炎患者,并与检测抗-HEV IgM的方法进行比较.结果 126例急性戊型肝炎患者血清中有67例HEV-RNA阳性,对照组血清HEV-RNA检测均为阴性;与血清抗HEV IgM检测结果比较,HEV RNA检测的总符合率为80.91％,两种方法的检测结果具有良好的一致性;nRT-PCR方法检测HEV-RNA与血清抗-HEV IgM检测方法存在明显的差异,不能相互替代,而有一定的互补性;3例患者的首份血清检测为HEV-RNA阳性,但抗-HEV IgM为阴性,系列追踪检测,均相继出现抗HEV IgM,急性戊型肝炎患者血清HEV-RNA的检出多在发病的1～12 d.结论 应用nRT-PCR方法能对急性散发戊型肝炎患者血清中的HEV RNA进行定性检测,且有较高的特异性和敏感性,临床使用可以提高对HEV早期诊断的水平,具有一定的临床应用价值.     

Hepatitis E virus and neurologic disorders

Information about the spectrum of disease caused by hepatitis E virus (HEV) genotype 3 is emerging. During 2004-2009, at 2 hospitals in the United Kingdom and France, among 126 patients with locally acquired acute and chronic HEV genotype 3 infection, neurologic complications developed in 7 (5.5%): inflammatory polyradiculopathy (n = 3), Guillain-Barre syndrome (n = 1), bilateral brachial neuritis (n = 1), encephalitis (n = 1), and ataxia/proximal myopathy (n = 1). Three cases occurred in nonimmunocompromised patients with acute HEV infection, and 4 were in immunocompromised patients with chronic HEV infection. HEV RNA was detected in cerebrospinal fluid of all 4 patients with chronic HEV infection but not in that of 2 patients with acute HEV infection. Neurologic outcomes were complete resolution (n = 3), improvement with residual neurologic deficit (n = 3), and no improvement (n = 1). Neurologic disorders are an emerging extrahepatic manifestation of HEV infection.     

First report of acute autochthonous hepatitis E in Portugal

Hepatitis E infection is usually a self-limiting disease. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described; their number seems to be increasing in European countries. We report the first human case of autochthonous acute hepatitis E confirmed in Portugal. Patients with acute non-A-C hepatitis should be tested for HEV in Portugal and hepatitis E infection should be considered in the differential diagnosis of unexplained hepatitis cases.     

戊型病毒性肝炎研究进展

戊型病毒性肝炎（戊肝）是由戊肝病毒（HepatitisE Virus,HEV）引起的急性病毒性肝炎。HEV是一种单链、非包膜的RNA病毒,分为4个基因型,主要通过粪口途径传播,也可以通过输血传播和母婴传播。戊肝主要在发展中国家流行,但欧美等发达国家亦有散发病例。戊肝是一种人畜共患病。酶联免疫吸附实验（ELISA）是目前用于检测血清HEV抗体最常用的方法。HEV RNA检测可证实HEV感染。目前,HEV疫苗的研究主要集中在HEV基因工程疫苗的研制。2012年10月HEV疫苗上市。采用切断传播途径为主的综合性预防措施可控制该病的流行,接种疫苗也是预防戊型肝炎的重要措施。     

戊型肝炎病毒ORF3蛋白功能的研究进展

戊型肝炎是一种由戊型肝炎病毒(HEV)引起的经肠道传播的病毒性肝炎。对HEV结构蛋白的深入研究有利于病毒感染机制的明确和疾病的预防。ORF3蛋白作为HEV结构蛋白之一,其具体功能目前仍不太清楚。一直以来,针对该蛋白的研究非常少,近年来研究发现HEV ORF3蛋白在细胞信号转导、病毒感染和免疫抑制等方面都有非常重要的作用。     

武汉地区戊型肝炎流行病学特点调查

目的调查武汉地区普通人群戊型肝炎病毒（HEV）感染的流行病学特点。方法2006年1—12月来武汉科技大学附属汉阳医院常规体检人员进行整群抽样并抽血,应用ELISA方法检测血清中戊型肝炎病毒（HEV）IgG水平,同时检测体检人员血清ALT水平,用统计学方法分析本地区普通人群HEV感染情况及特点。结果常规体检的3561人员中HEV总感染率为30．50％,HEV-IgG阳性率男性为37．92％,女性为23．31％;20岁以下人群阳性率〈1％,男性比女性感染率高,感染率随年龄上升而上升。HEV—IgG阳性人群ALT水平与HEV-IgG阴性人群无显著性差异。结论武汉地区男性和年长人群具有较高的HEV感染风险,20岁以下人群中HEV—IgG阳性率极低,学校等地方戊肝暴发的预防应引起高度重视。     

Hepatitis E virus infection in HIV-infected persons

To determine whether hepatitis E virus (HEV) is a cause of hepatitis among HIV-infected persons, we evaluated 1985-2009 data for US military beneficiaries. Evidence of acute or prior HEV infection was detected for 7 (4%) and 5 (3%) of 194 HIV-infected persons, respectively. HEV might be a cause of acute hepatitis among HIV-infected persons.     

戊型肝炎病毒的研究概况及进展

戊型肝炎病毒(HEV)是引起戊型肝炎(HE)的病原体。HE呈全球性分布,主要侵犯青壮年,其中孕妇死亡率高达20%。近些年来包括美国、中国、日本、印度在内的一些发达及发展中国家和地区,HE人群感染率呈上升趋势,控制该病刻不容缓。文中针对HEV的研究现状,从HEV的生物学特征、基因分型、细胞模型和动物模型、疫苗及诊断试剂的研究等方面进行综述。     

Role of hepatitis E and other hepatotropic virus in aetiology of sporadic acute viral hepatitis: A hospital based study from urban Delhi

Major hepatotropic virus continues to be an important cause of acute viral hepatitis (AVH) in developing countries like India. While epidemics of AVH have been well studied few serious sporadic cases from developing countries have been reviewed. We studied prospectively 75 cases of sporadic AVH who reported to our hospital and were evaluated for the presence of various hepatotropic viruses. The seroprevalence of IgG anti-HEV antibodies was studied in the general population as a control. We found 53.3% (40/75) of sporadic AVH cases were due to hepatitis E virus while 11% (8/75) were due to hepatitis B virus. Hepatitis C virus was responsible for 8% (6/75) of the sporadic AVH cases and hepatitis A was found in 5% (4/75) of the cases. No causative agent was found in 23% (17/75) of the sporadic AVH cases. The sporadic AVH cases due to HEV were not clinically or biochemically not different from AVH due to other viruses. We found a high prevalence of IgG anti-HEV in 35.6% (178/500) among the general population of urban Delhi. The study suggested that hepatitis E was the most common cause of sporadic AVH in urban Delhi. High seroprevalence of IgG anti-HEV antibodies in the general population and amongst the sporadic AVH cases suggests that it is unlikely to be protective antibody. IgM anti-HEV positive serology is considered diagnostic of acute hepatitis E infection in India, where hepatitis E is endemic.     

Human and porcine hepatitis E virus strains, United Kingdom

We describe a case of acquired infection of a strain of hepatitis E virus (HEV) with a 100% amino acid identity to the analogous region in strains of HEV circulating in a United Kingdom pig herd. This case further supports the theory that autochthonous HEV infection in industrialized countries is zoonotic.     

戊型病毒性肝炎研究进展

戊型病毒性肝炎（戊肝）约占临床急性散发性病毒性肝炎的10%～20%,病死率约0.5%～1.5%,孕妇戊肝病人的病死率可高达20%。中国是戊肝的高流行区。戊肝病毒主要通过肠道传播,亦有证据表明可以通过血液传播。近年来,随着对戊肝病原学、流行病学研究的深入开展,诊断试剂及疫苗研发进展迅速,现对戊肝的流行病学、诊断学及疫苗研究作一综述。     

Hepatitis E Virus Antibodies in Patients with Chronic Liver Disease

In the United States, the seroprevalence rate for hepatitis E virus (HEV) is ≈20%. This study examined HEV seroprevalence in persons with and without chronic liver disease. Our data indicate that HEV seropositivity is high in patients with chronic liver disease and that HEV seroprevalence increases significantly with age.     

戊型肝炎病毒的动物宿主研究进展

戊型肝炎病毒 (hepatitisEvirus,HEV)是 1 982年发现的一种新型肝炎病毒[1 ] ,当时称为肠道传播的非甲非乙型肝炎病毒 ,1 989年正式命名为HEV。其基因组为单股正链RNA ,全长约 7.2kb,基因组编码区有 3个开放读码框架(ORFs)。HEV至少有 8个基因型[2 ] ;基因 1型和 2型分别为亚非型和墨西哥型 ;美国的猪和人HEV为基因 3型 ;中国的北京株和台湾株HEV属于基因 4型 ;欧洲株、意大利株和希腊株等属于HEV基因 5～ 8型。HEV主要经粪 口途径传播 ,有流行和散发两种形式。流行主要发生在发展中国家 ,多因水源被污染引起。散发主要发生在欧…     

抗-戊型肝炎病毒单克隆抗体的研制及应用

目的研究戊型肝炎病毒（ＨＥＶ）颗粒，对戊型肝炎进行特异的诊断。方法采用基因工程表达的戊型肝炎病毒抗原作为免疫源，用ＥＬＩＳＡ间接法以纯化的人工合成多肽抗原检测。结果研制出４株稳定分泌抗ＨＥＶ的单克隆抗体（ＭｃＡｂ）５Ｂ１２、５Ｆ１、５Ｂ９和４Ｇ１０，所制备出的抗ＨＥＶ单克隆抗体与抗ＨＥＶ阳性血清可产生抑制反应；亦可与ＨＥＶ病毒颗粒特异地结合，形成在电镜下清晰可见的病毒抗体复合物。结论这种方法制备的ＭｃＡｂ特异性高，可用于病毒的检测和鉴定     

淮安市戊型病毒性肝炎人畜共患性及病毒基因型研究

目的探讨淮安市戊型病毒性肝炎病例与猪之间的联系,为控制HEV在人畜间的传播提供依据。方法在淮安市收集急性戊肝、肝炎未分型病例血液标本193份,同期在屠宰场收集生猪胆囊标本510份,采用Real-time RT-PCR和RT-PCR提取目标核苷酸,测定序列后进行分析。结果所有标本共分离出HEV-4型毒株20株,分4个亚型,HEV-4d型为优势流行毒株亚型;人源与猪源HEV毒株间的同源性为:80.3%～97.7%。结论淮安市戊肝病例与生猪感染的HEV高度同源,生猪是戊肝传播过程中一种重要的动物宿主。     

Development of a vectored vaccine against Hepatitis E virus

Hepatitis E virus is a non-enveloped ssRNA virus [1] that causes human acute hepatitis through primarily fecal and oral transmission [2]. Currently, no commercial hepatitis E (HEV) vaccine is available. In the absence of an appropriate cell culture system for HEV propagation, HEV pseudocapsids (ORF2 protein) have been produced either in Escherichia coli or in insect cells and they have been shown to protect monkeys against virus challenge and to be effective in the prevention of natural HEV infection of humans.     

慢性乙肝患者重叠急性戊肝对临床转归的影响

目的探讨慢性乙肝患者重叠急性戊肝对临床转归的影响。方法将55例慢性乙肝患者分成两组,一组25例为乙肝合并戊肝急性感染,另一组30例为单纯慢性乙肝组,对两组进行临床特点的对照分析。结果乙肝合并戊肝急性感染组黄疸深[TB（319.78±153.94）μmol/L）],血清白蛋白更低[（33.39±5.17）g/L],凝血功能恶化[PTA（52.92±28.04）%],重肝发生率（40%）、并发症发生率（32%）及死亡率（12%）均明显高于单纯乙肝组（P〈0.05）。结论慢性乙肝重叠戊肝急性感染可诱发慢性肝炎活动及重症化,并发症增多,病死率高,预后差。     

中国南方某农村地区人与猪戊型肝炎病毒的检测和部分序列分析

目的调查中国南方某农村地区戊型肝炎病毒（HEV）人株与猪株的相关性。方法应用逆转录-巢式聚合酶链法（RT—nPCR）对一般人群中HEV-IgM阳性者、急性戊型肝炎患者和当地某养猪场的猪进行HEV RNA检测，并对HEV RNA阳性标本进行克隆测序和序列分析。结果132份猪粪便标本中13份为HEV RNA阳性；26份IgM阳性一般人群血清标本中有4份HEV RNA阳性；4例急性戊型肝炎患者中有1例的血清和粪便标本为阳性。序列分析发现该地区HEV人株与猪株在ORF2部分区域的核苷酸序列同源性为89．3％～100．0％，这10株HEV序列与HEVⅠ型、Ⅱ型、Ⅲ型和Ⅳ型在同一区域的核苷酸序列的同源性分别为78．7％～84．7％、83．3％～85．3％、76．0％～80．0％和84．7％～95．3％。结论该地区人群及猪群中流行的HEV同属基因Ⅳ型。     

广西地区野鼠戊型肝炎病毒相关抗体的血清流行病学

目的调查广西地区野鼠有无戊型肝炎病毒感染以及相关抗体的阳性率。方法利用HEV核衣壳蛋白的不同多肽片断作为包被抗原,采用酶免疫法测定广西地区556只各种野鼠外周血抗-HEV。结果556只各种野鼠中,共有90只(16.2%)抗-HEV阳性。其中,353只褐家鼠中,68只(19.3%)阳性,152只黄胸鼠中,22只(14.5%)阳性,两组阳性率差异无显著意义(P>0.1);51只其他鼠类(板齿鼠、竹鼠、鼷鼠、小家鼠)均未测出抗-HEV。不同地区鼠类的抗体阳性率不同,农村明显高于城市(P<0.05),卫生状况差的地点鼠类抗体阳性率最高。结论广西地区的野鼠中大约16%有抗-HEV抗体存在,这些野鼠感染过HEV或HEV相关病毒,但这些鼠类是否构成相关病毒的宿主还有待于进一步的研究。