摘要
戊型肝炎病毒(HEV)感染是全球范围急性病毒性肝炎最常见的原因。在过去十年,HEV被发现不仅能引起急性自限性疾病,还可导致重症及慢性感染。HEV感染孕妇或基础肝病患者后易发展为肝衰竭,病死率较高;HEV感染实体器官移植患者易发展为慢性肝炎。本文介绍了HEV重症及慢性感染的诊断、临床特征、传播方式、预防和治疗,重点探讨了HEV重症化和慢性化过程中免疫反应、炎症反应以及病毒本身的特征,并总结其促进HEV病程进展的机制。然而,现有研究与临床应用之间仍然存在鸿沟,目前仍然缺乏针对重症及慢性HEV的较好的诊疗方案。临床研究人员需要不断推进戊型肝炎发病机制及系统的队列研究,同时提高临床护理水平,最终实现预防和改善戊型肝炎患者预后的目标。
Hepatitis E virus(HEV)infection is the most common cause of acute viral hepatitis worldwide,and over the past ten years,studies have shown that HEV can not only cause acute self-limiting hepatitis,but also lead to severe and chronic infection.Pregnant women or patients with underlying liver disease may progress to liver failure after HEV infection,resulting in a relatively high mortality rate,and patients receiving solid organ transplantation may progress to chronic hepatitis after HFV infection.This article introduces the diagnosis,clinical features,transmission,prevention,and treatment of severe and chronic HEV infection,discusses the features of immune response,inflammatory response,and the virus itself during the severe exacerbation and chronicity of HEV infection,and summarizes the mechanism in promoting the progression of HEV.Nevertheless,there are still large gaps between current studies and clinical application,and there is still a lack of effective diagnosis and treatment regimens for severe and chronic HEV infection.It is necessary for clinical researchers to conduct research on the pathogenesis of hepatitis E and systematic cohort studies and improve the level of clinical nursing,thereby achieving the goal of preventing hepatitis E and improving the prognosis of patients with hepatitis E.
作者
陈俞心
王艺瑾
CHEN Yuxin;WANG Yijin(Medical School of Southern University of Science and Technology,Shenzhen,Guangdong 518055,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2023年第11期2530-2537,共8页
Journal of Clinical Hepatology
