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Transfusion-transmitted hepatitis E:What we know so far?
作者姓名:Carmen Ka Man Cheung  Sunny Hei Wong  Alvin Wing Hin Law  Man Fai Law
作者单位:Medicine and Therapeutics;Institute of Digestive Disease and Department of Medicine and Therapeutics;Lee Kong Chian School of Medicine;West Island School
摘    要:Hepatitis E virus(HEV)is a major cause of viral hepatitis globally.There is growing concern about transfusion-transmitted HEV(TT-HEV)as an emerging global health problem.HEV can potentially result in chronic infection in immunocompromised patients,leading to a higher risk of liver cirrhosis and even death.Between 0.0013%and 0.281%of asymptomatic blood donors around the world have HEV viremia,and 0.27%to 60.5%have anti-HEV immunoglobulin G.HEV is infectious even at very low blood concentrations of the virus.Immunosuppressed patients who develop persistent hepatitis E infection should have their immunosuppressant regimen reduced;ribavirin may be considered as treatment.Pegylated interferon can be considered in those who are refractory or intolerant to ribavirin.Sofosbuvir,a nucleotide analog,showed modest antiviral activity in some clinical studies but sustained viral response was not achieved.Therefore,rescue treatment remains an unmet need.The need for HEV screening of all blood donations remains controversial.Universal screening has been adopted in some countries after consideration of risk and resource availability.Various pathogen reduction methods have also been proposed to reduce the risk of TT-HEV.Future studies are needed to define the incidence of transmission through transfusion,their clinical features,outcomes and prognosis.

关 键 词:Hepatitis  E  virus  Acute  and  chronic  hepatitis  IMMUNOSUPPRESSION  Blood  transfusion  TRANSPLANTATION
收稿时间:2021-04-10
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