乙戊型肝炎病毒重叠感染的研究进展
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摘要
戊型肝炎(简称"戊肝")是发展中国家发病率最高的急性病毒性肝炎,疾病负担较重,近年来发达国家也出现越来越多散发的本土病例。我国慢性乙型肝炎(简称"慢乙肝")人群基数大,慢乙肝患者重叠感染戊肝病毒之后,可加重患者病情,增加肝硬化、肝衰竭以及死亡的发生风险。本文拟对乙型肝炎病毒重叠感染戊肝病毒的流行病学特征、临床特征及预防措施进行综述。
Hepatitis E is the most common type of acute viral hepatitis in developing countries,and the disease burden is heavy. In recent years,more and more local cases have also presented in developed countries. The Chronic hepatitis B population of China is large,and chronic hepatitis B patients are prone to superinfection with hepatitis E virus,which aggravates the patient′s condition,increasing the risk of cirrhosis,liver failure and death. This article aims to summarize the epidemiological characteristics and clinical features of,and preventive measures for hepatitis B virus superinfection with hepatitis E virus.
Hepatitis E is the most common type of acute viral hepatitis in developing countries,and the disease burden is heavy. In recent years,more and more local cases have also presented in developed countries. The Chronic hepatitis B population of China is large,and chronic hepatitis B patients are prone to superinfection with hepatitis E virus,which aggravates the patient′s condition,increasing the risk of cirrhosis,liver failure and death. This article aims to summarize the epidemiological characteristics and clinical features of,and preventive measures for hepatitis B virus superinfection with hepatitis E virus.
引文
[1] Kamar N,Dalton H R,Abravanel F,Izopet J. Hepati-tis E virus infection[J]. Clin Microbiol Rev,2014,27(1):116-138.
[2] Kamar N,Selves J,Mansuy J M,Ouezzani L,Péron J M,Guitard J,Cointault O,Esposito L,Abravanel F,Danjoux M. Hepatitis E virus and chronic hepatitis in or-gan-transplant recipients[J]. N Engl J Med,2008,358(8):811-817.
[3] Choi M,Hofmann J,K??Hler A,Wang B,Bock CT,Schott E,Reinke P,Nickel P. Prevalence and clinical correlates of chronic hepatitis E infection in German re-nal transplant recipients with elevated liver enzymes[J/OL]. Transplant Direct,2018,4(2):e341.
[4] Dalton H R B R,Keane F E,Tedder R S,Ijaz S. Per-sistent carriage of hepatitis E virus in patients with HIV infection[J]. N Engl J Med,2009,361(10):1025-1027.
[5] Tavitian S,Péron J M,Huynh A,Mansuy J M,Yse-baert L,Huguet F,Vinel J P,Attal M,Izopet J,Récher C. Hepatitis E virus excretion can be prolonged in patients with hematological malignancies[J]. J Clin Virol,2010,49(2):141-144.
[6] Kamar N,Bendall R,Legrand-Abravanel F,Xia N S,Ijaz S,Izopet J,Dalton H R,Hepatitis E[J]. Lancet,2012,379(9835):2477-2488.
[7] Pokorny A M,Pokorny C S. Local outbreak of hepatitis E:a rare cause of viral hepatitis in Australia[J]. Intern Med J,2015,45(12):1300-1302.
[8] Harry R Dalton N K,Jacques Izopet. Hepatitis E in de-veloped countries current status and future perspectives[J]. Future Microbiol,2014,9(12):1361-72.
[9] WHO. Hepatitis E Vaccine[EB/OL]http://www.who.int/wer/2015/wer9018.
[10]WHO. Hepatitis E[EB/OL]http://www.who.int/en/news-room/fact-sheets/detail/hepatitis-e.
[11]Anty R,Ollier L,Peron J M,Nicand E,Cannavo I,Bongain A,Giordanengo V,Tran A. First case report of an acute genotype 3 hepatitis E infected pregnant woman living in South-Eastern France[J]. J Clin Virol,2012,54(1):76-78.
[12]Zhu F C,Huang S J,Wu T,Zhang X F,Wang Z Z,Ai X,Yan Q,Yang C L,Cai J P,Jiang H M. Epidemi-ology of Zoonotic Hepatitis E:A Community-Based Sur-veillance Study in a Rural Population in China[J/OL].PLoS One,2014,9(1):e87154.
[13]Zhang X,Ke W,Xie J,Zhao Z,Xie D,Gao Z. Com-parison of effects of hepatitis E or A viral superinfection in patients with chronic hepatitis B[J]. Hepatol Int,2010,4(3):615-620.
[14]WHO. Hepatitis B[EB/OL]http://www.who.int/en/news-room/fact-sheets/detail/hepatitis-b.
[15]Chen S,Li J,Wang D,Fung H,Wong Ly,Zhao L.The hepatitis B epidemic in China should receive more attention[J]. Lancet,2018,391(10130):1572.
[16]贺新春,刘建湘.戊型肝炎对乙型肝炎感染肝功能及预后的影响[J].中国现代医学杂志,2013,23(31):104-107.
[17]Zhu F C,Huang S J,Wu T,Zhang X F,Wang Z Z,Ai X,Yan Q,Yang C L,Cai J P,Jiang H M,Wang Y J,Ng M H,Zhang J,Xia N S. Epidemiology of zoonot-ic hepatitis E:a community-based surveillance study in a rural population in China[J]. PLoS One,2014,9(1):e87154.
[18]Lai J C,Wong G L,Yip T C,Tse Y K,Lam K L,Lui G C,Chan H L,Wong V W. Chronic Hepatitis B Increases Liver-Related Mortality of Patients With Acute Hepatitis E:A Territorywide Cohort Study From2000 to 2016[J]. Clin Infect Dis,2018,67(8):1278-1284.
[19]Hoan N X,Tong H V,Hecht N,Sy B T,Marcinek P,Meyer C G,Song L H,Toan N L,Kurreck J,Krems-ner P G,Bock C T,Velavan T P. Hepatitis E virus su-perinfection and clinical progression in hepatitis B pa-tients[J]. EBio Medicine,2015,2(12):2080-2086.
[20]Fu J,Guo D,Gao D,Huang W,Li Z,Jia B. Clinical analysis of patients suffering from chronic hepatitis B su-perinfected with other hepadnaviruses[J]. J Med Virol,2016,88(6):1003-1009.
[21]Chen C,Zhang S Y,Zhang D D,Li X Y,Zhang Y L,Li W X,Yan J J,Wang M,Xun J N,Lu C,Ling Y,Huang Y X,Chen L. Clinical features of acute hepatitis E super-infections on chronic hepatitis B[J]. World J Gastroenterol,2016,22(47):10388-10397.
[22]李蔚莉.戊型肝炎重叠乙型肝炎感染的临床特征分析[J].中华医院感染学杂志,2010,20(21):3329-3331.
[23]廖宝林,林思炜,施海燕,何浩岚,张坚生,蔡卫平. 334例慢性乙型肝炎重叠感染戊型肝炎病毒患者临床特征分析[J].中华肝脏病杂志,2015,23(9):697-699.
[24]付佳.慢性乙型病毒性肝炎重叠感染其它嗜肝性病毒性肝炎的临床分析[D].重庆医科大学,2016.
[25]张国顺,冯福民,李玉林,哀聚祥,尚华.慢性乙型肝炎重叠戊型肝炎病毒感染的研究[J].中华肝脏病杂志,2006,14(12):906-908.
[26]商庆华,于建国,肖德明,徐传镇,陈崇兴,张光曙.慢性乙型肝炎患者重叠戊型肝炎病毒感染的临床与病理学研究[J].中华内科杂志,2002,41(10):656-659.
[27]Kumar M,Sharma B C,Sarin S K. Hepatitis E virus as an etiology of acute exacerbation of previously unrecog-nized asymptomatic patients with hepatitis B virus-relat-ed chronic liver disease[J]. J Gastroen Hepatol,2008,23(6):883-887.
[28]Cheng S H,Mai L,Zhu F Q,Pan X F,Sun H X,Cao H,Shu X,Ke W M,Li G,Xu Q H. Influence of chron-ic HBV infection on superimposed acute hepatitis E[J].World J Gastroentero,2013,19(35):5904-5909.
[29]Zhang L,Jiang Z,Lv J,Liu J,Yan B,Feng Y,Li L,Zhang G,Wang F,Xu A. Comparison of hepatitis E vi-rus seroprevalence between HBsAg-positive population and healthy controls in Shandong province,China[J].Bmc Infect Dis,2018,18(1):75.
[30]张苏宁,赵守松.慢性乙型肝炎与急性戊型肝炎重叠感染机制研究进展[J].内科,2011,06(1):55-58.
[31]Zhang J,Zhao Q J,Xia N S. Prophylactic Hepatitis E Vaccine[J]. Hepatitis E Virus,2016,948:223-246.
[32]Zhang J,Zhang X F,Huang S J,Wu T,Hu Y M,Wang Z Z,Wang H,Jiang H M,Wang Y J,Yan Q,Guo M,Liu X H,Li J X,Yang C L,Tang Q,Jiang R J,Pan H R,Li Y M,Shih J W,Ng M H,Zhu F C,Xia N S. Long-term efficacy of a hepatitis E vaccine[J].New Engl J Med,2015,372(10):914-922.
[33]Su Y Y,Huang S J,Guo M,Zhao J,Yu H,He W G,Jiang H M,Wang Y J,Zhang X F,Cai J P,Yang C L,Wang Z Z,Zhu F C,Wu T,Zhang J,Xia N S. Persis-tence of antibodies acquired by natural hepatitis E virus infection and effects of vaccination[J]. Clin Microbiol In-fect,2017,23(5):336.e1-336.e4.
[34]Zhu F C,Zhang J,Zhang X F,Zhou C,Wang Z Z,Huang S J,Wang H,Yang C L,Jiang H M,Cai J P,Wang Y J,Ai X,Hu Y M,Tang Q A,Yao X,Yan Q A,Xian Y L,Wu T,Li Y M,Miao J,Ng M H,Shih JWK,Xia N S. Efficacy and safety of a recombinant hep-atitis E vaccine in healthy adults:a large-scale,ran-domised,double-blind placebo-controlled,phase 3 trial[J]. Lancet,2010,376(9744):895-902.
[35]Wu T,Zhu F C,Huang S J,Zhang X F,Wang Z Z,Zhang J,Xia N S. Safety of the hepatitis E vaccine for pregnant women:a preliminary analysis[J]. Hepatolo-gy,2012,55(6):2038-2038.
[36]Wu T,Huang S J,Zhu F C,Zhang X F,Ai X,Yan Q,Wang Z Z,Yang C L,Jiang H M,Liu X H,Guo M,Du H L,Ng M H,Zhang J,Xia N S. Immunoge-nicity and safety of hepatitis E vaccine in healthy hepati-tis B surface antigen positive adults[J]. Hum Vaccin Im-munother,2013,9(11):2474-2479.
[37]崔富强,庄辉,中国乙型肝炎的流行及控制进展[J].中国病毒病杂志,2018,8(4):257-264.
[38]Murali A R,Kotwal V,Chawla S. Chronic hepatitis E:a brief review[J]. World J of Hepatol,2015,7(19):2194-2201.
[39]Juliana Ayres de Alencar Arrais Guerra,Katia Cristina Kampa,Daphne Gon?alves Benatti Morsoletto,Alcindo Pissaia Junior,Cláudia Alexandra Pontes Ivantes. Hepa-titis E:a literature review[J]. J Clin Transl Hepatol.2017,5(4):376–383.
[2] Kamar N,Selves J,Mansuy J M,Ouezzani L,Péron J M,Guitard J,Cointault O,Esposito L,Abravanel F,Danjoux M. Hepatitis E virus and chronic hepatitis in or-gan-transplant recipients[J]. N Engl J Med,2008,358(8):811-817.
[3] Choi M,Hofmann J,K??Hler A,Wang B,Bock CT,Schott E,Reinke P,Nickel P. Prevalence and clinical correlates of chronic hepatitis E infection in German re-nal transplant recipients with elevated liver enzymes[J/OL]. Transplant Direct,2018,4(2):e341.
[4] Dalton H R B R,Keane F E,Tedder R S,Ijaz S. Per-sistent carriage of hepatitis E virus in patients with HIV infection[J]. N Engl J Med,2009,361(10):1025-1027.
[5] Tavitian S,Péron J M,Huynh A,Mansuy J M,Yse-baert L,Huguet F,Vinel J P,Attal M,Izopet J,Récher C. Hepatitis E virus excretion can be prolonged in patients with hematological malignancies[J]. J Clin Virol,2010,49(2):141-144.
[6] Kamar N,Bendall R,Legrand-Abravanel F,Xia N S,Ijaz S,Izopet J,Dalton H R,Hepatitis E[J]. Lancet,2012,379(9835):2477-2488.
[7] Pokorny A M,Pokorny C S. Local outbreak of hepatitis E:a rare cause of viral hepatitis in Australia[J]. Intern Med J,2015,45(12):1300-1302.
[8] Harry R Dalton N K,Jacques Izopet. Hepatitis E in de-veloped countries current status and future perspectives[J]. Future Microbiol,2014,9(12):1361-72.
[9] WHO. Hepatitis E Vaccine[EB/OL]http://www.who.int/wer/2015/wer9018.
[10]WHO. Hepatitis E[EB/OL]http://www.who.int/en/news-room/fact-sheets/detail/hepatitis-e.
[11]Anty R,Ollier L,Peron J M,Nicand E,Cannavo I,Bongain A,Giordanengo V,Tran A. First case report of an acute genotype 3 hepatitis E infected pregnant woman living in South-Eastern France[J]. J Clin Virol,2012,54(1):76-78.
[12]Zhu F C,Huang S J,Wu T,Zhang X F,Wang Z Z,Ai X,Yan Q,Yang C L,Cai J P,Jiang H M. Epidemi-ology of Zoonotic Hepatitis E:A Community-Based Sur-veillance Study in a Rural Population in China[J/OL].PLoS One,2014,9(1):e87154.
[13]Zhang X,Ke W,Xie J,Zhao Z,Xie D,Gao Z. Com-parison of effects of hepatitis E or A viral superinfection in patients with chronic hepatitis B[J]. Hepatol Int,2010,4(3):615-620.
[14]WHO. Hepatitis B[EB/OL]http://www.who.int/en/news-room/fact-sheets/detail/hepatitis-b.
[15]Chen S,Li J,Wang D,Fung H,Wong Ly,Zhao L.The hepatitis B epidemic in China should receive more attention[J]. Lancet,2018,391(10130):1572.
[16]贺新春,刘建湘.戊型肝炎对乙型肝炎感染肝功能及预后的影响[J].中国现代医学杂志,2013,23(31):104-107.
[17]Zhu F C,Huang S J,Wu T,Zhang X F,Wang Z Z,Ai X,Yan Q,Yang C L,Cai J P,Jiang H M,Wang Y J,Ng M H,Zhang J,Xia N S. Epidemiology of zoonot-ic hepatitis E:a community-based surveillance study in a rural population in China[J]. PLoS One,2014,9(1):e87154.
[18]Lai J C,Wong G L,Yip T C,Tse Y K,Lam K L,Lui G C,Chan H L,Wong V W. Chronic Hepatitis B Increases Liver-Related Mortality of Patients With Acute Hepatitis E:A Territorywide Cohort Study From2000 to 2016[J]. Clin Infect Dis,2018,67(8):1278-1284.
[19]Hoan N X,Tong H V,Hecht N,Sy B T,Marcinek P,Meyer C G,Song L H,Toan N L,Kurreck J,Krems-ner P G,Bock C T,Velavan T P. Hepatitis E virus su-perinfection and clinical progression in hepatitis B pa-tients[J]. EBio Medicine,2015,2(12):2080-2086.
[20]Fu J,Guo D,Gao D,Huang W,Li Z,Jia B. Clinical analysis of patients suffering from chronic hepatitis B su-perinfected with other hepadnaviruses[J]. J Med Virol,2016,88(6):1003-1009.
[21]Chen C,Zhang S Y,Zhang D D,Li X Y,Zhang Y L,Li W X,Yan J J,Wang M,Xun J N,Lu C,Ling Y,Huang Y X,Chen L. Clinical features of acute hepatitis E super-infections on chronic hepatitis B[J]. World J Gastroenterol,2016,22(47):10388-10397.
[22]李蔚莉.戊型肝炎重叠乙型肝炎感染的临床特征分析[J].中华医院感染学杂志,2010,20(21):3329-3331.
[23]廖宝林,林思炜,施海燕,何浩岚,张坚生,蔡卫平. 334例慢性乙型肝炎重叠感染戊型肝炎病毒患者临床特征分析[J].中华肝脏病杂志,2015,23(9):697-699.
[24]付佳.慢性乙型病毒性肝炎重叠感染其它嗜肝性病毒性肝炎的临床分析[D].重庆医科大学,2016.
[25]张国顺,冯福民,李玉林,哀聚祥,尚华.慢性乙型肝炎重叠戊型肝炎病毒感染的研究[J].中华肝脏病杂志,2006,14(12):906-908.
[26]商庆华,于建国,肖德明,徐传镇,陈崇兴,张光曙.慢性乙型肝炎患者重叠戊型肝炎病毒感染的临床与病理学研究[J].中华内科杂志,2002,41(10):656-659.
[27]Kumar M,Sharma B C,Sarin S K. Hepatitis E virus as an etiology of acute exacerbation of previously unrecog-nized asymptomatic patients with hepatitis B virus-relat-ed chronic liver disease[J]. J Gastroen Hepatol,2008,23(6):883-887.
[28]Cheng S H,Mai L,Zhu F Q,Pan X F,Sun H X,Cao H,Shu X,Ke W M,Li G,Xu Q H. Influence of chron-ic HBV infection on superimposed acute hepatitis E[J].World J Gastroentero,2013,19(35):5904-5909.
[29]Zhang L,Jiang Z,Lv J,Liu J,Yan B,Feng Y,Li L,Zhang G,Wang F,Xu A. Comparison of hepatitis E vi-rus seroprevalence between HBsAg-positive population and healthy controls in Shandong province,China[J].Bmc Infect Dis,2018,18(1):75.
[30]张苏宁,赵守松.慢性乙型肝炎与急性戊型肝炎重叠感染机制研究进展[J].内科,2011,06(1):55-58.
[31]Zhang J,Zhao Q J,Xia N S. Prophylactic Hepatitis E Vaccine[J]. Hepatitis E Virus,2016,948:223-246.
[32]Zhang J,Zhang X F,Huang S J,Wu T,Hu Y M,Wang Z Z,Wang H,Jiang H M,Wang Y J,Yan Q,Guo M,Liu X H,Li J X,Yang C L,Tang Q,Jiang R J,Pan H R,Li Y M,Shih J W,Ng M H,Zhu F C,Xia N S. Long-term efficacy of a hepatitis E vaccine[J].New Engl J Med,2015,372(10):914-922.
[33]Su Y Y,Huang S J,Guo M,Zhao J,Yu H,He W G,Jiang H M,Wang Y J,Zhang X F,Cai J P,Yang C L,Wang Z Z,Zhu F C,Wu T,Zhang J,Xia N S. Persis-tence of antibodies acquired by natural hepatitis E virus infection and effects of vaccination[J]. Clin Microbiol In-fect,2017,23(5):336.e1-336.e4.
[34]Zhu F C,Zhang J,Zhang X F,Zhou C,Wang Z Z,Huang S J,Wang H,Yang C L,Jiang H M,Cai J P,Wang Y J,Ai X,Hu Y M,Tang Q A,Yao X,Yan Q A,Xian Y L,Wu T,Li Y M,Miao J,Ng M H,Shih JWK,Xia N S. Efficacy and safety of a recombinant hep-atitis E vaccine in healthy adults:a large-scale,ran-domised,double-blind placebo-controlled,phase 3 trial[J]. Lancet,2010,376(9744):895-902.
[35]Wu T,Zhu F C,Huang S J,Zhang X F,Wang Z Z,Zhang J,Xia N S. Safety of the hepatitis E vaccine for pregnant women:a preliminary analysis[J]. Hepatolo-gy,2012,55(6):2038-2038.
[36]Wu T,Huang S J,Zhu F C,Zhang X F,Ai X,Yan Q,Wang Z Z,Yang C L,Jiang H M,Liu X H,Guo M,Du H L,Ng M H,Zhang J,Xia N S. Immunoge-nicity and safety of hepatitis E vaccine in healthy hepati-tis B surface antigen positive adults[J]. Hum Vaccin Im-munother,2013,9(11):2474-2479.
[37]崔富强,庄辉,中国乙型肝炎的流行及控制进展[J].中国病毒病杂志,2018,8(4):257-264.
[38]Murali A R,Kotwal V,Chawla S. Chronic hepatitis E:a brief review[J]. World J of Hepatol,2015,7(19):2194-2201.
[39]Juliana Ayres de Alencar Arrais Guerra,Katia Cristina Kampa,Daphne Gon?alves Benatti Morsoletto,Alcindo Pissaia Junior,Cláudia Alexandra Pontes Ivantes. Hepa-titis E:a literature review[J]. J Clin Transl Hepatol.2017,5(4):376–383.