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1、GASTROENTEROLOGY2012;142:1388–1397PathogenesisandTreatmentofHepatitisEVirusInfectionHeinerWedemeyerSvenPischkeMichaelP.MannsDepartmentofGastroenterology,HepatologyandEndocrinologyandIFB-TxIntegratedResearchandTreatmentCenterTransplantation,HannoverMedicalSchool,Hannover,GermanyHepatitisEhasbeenc
2、onsideredtobeatravel-associ-tocynomolgusmacaques,whichledtohepatitis.AnRNAated,acute,self-limitingliverdiseasethatcausesful-specieswasidentifiedfromliversofinfectedanimalsandHEPATITISEVIRUSminanthepaticfailureinspecifichigh-riskgroupsnamedhepatitisEvirus.4only.However,hepatitisEvirus(HEV)infection
3、canHEVisendemicinseveralAsianandAfricancountries,alsobeacquiredinindustrializedcountries—HEVge-wheretheprevalenceofHEVIgGantibodycouldbeasnotype3infectionisazoonosis,withpigsandrodentshighas50%.5IthasrecentlybeenestimatedthatHEVservingasanimalreservoirs.Inrecentyears,casesofinfectioncauses3mill
4、ionsymptomaticcasesofacutechronicHEVinfectionthatwereassociatedwithpro-hepatitisEeachyear,resultinginapproximately70,000gressiveliverdiseasehavebeendescribedinseveraldeathsworldwide.6Pregnantwomenandpatientswithcohortsofimmunocompromisedindividuals,includ-pre-existingchronicliverdiseasesareatapa
5、rticularriskofingrecipientsoforgantransplants.Thetopicofhep-fulminanthepaticfailureuponHEVinfection.Industri-atitisEisthereforere-emergingandhasraisedthealizedcountrieswereconsiderednonendemic,butanin-followingimportantquestions:whatistheriskforcreasingnumberofnon–travel-associatedcasesofHEVHEVi
6、nfectioninWesterncountries(eg,fromeatinginfectionshasbeenreportedinrecentyears,particularlyuncookedmeat)?Howfrequentlydoeschronichepa-inEurope.7–9ItisnotclearwhetherHEVincidenceratestitisEdevelopamonghumanimmunodeficiencyvi-arereallychangingorifmorecasesaredetectedthroughrus–infectedpatientsandre
7、cipientsoforgantrans-increasedsurveillance.7HepatitisEshouldalsobeconsid-plants?Whatarethetreatmentoptions?Whatistheeredinthedifferentialdiagnosisofdrug-inducedlivercurrentstatusofvaccinedevelopment?Whatdoweinjury,as3%ofpati
