Possible risk factors for the transmission of hepatitis E virus and for the severe form of hepatitis E acquired locally in Hokkaido, Japan
Possible risk factors for the transmission of hepatitis E virus and for the severe form of hepatitis E acquired locally in Hokkaido, Japan
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DOI：
10.1002/jmv.20364
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发表时间：
2005-07-01
影响因子：
12.7
通讯作者：
Okamoto, H
中科院分区：
文献类型：
--
作者：
Mizuo, H;Yazaki, Y;Okamoto, H
戊型肝炎在工业化国家尚未得到很好的研究。为了确定日本戊型肝炎病毒（HEV）传播和重型戊型肝炎的可能危险因素，我们调查了1996年至2004年期间在日本北海道感染轻度（n = 23）或重度（n = 9）戊型肝炎的32名患者的临床和病毒学特征。在北海道，戊型肝炎在日本最为流行。9例重度戊型肝炎患者包括2例暴发性戊型肝炎患者和7例诊断为重度急性肝炎的患者，尽管血浆凝血酶原活动度较低（≥ 20 mg/dl），但在病程中未出现肝性脑病。至少有25名患者（78%）在戊型肝炎发病前1-2个月食用了生或未煮熟的猪肝和/或猪肠。25例基因型4型患者ALT峰值显著高于基因型3型患者（P = 0.0338），而最低凝血酶原活动度显著低于基因型3型患者（P = 0.0340）。重度戊型肝炎与基础疾病的存在相关（56% [5/9] vs. 17% [4/23]，P = 0.0454）。该研究表明，人畜共患食源性戊型肝炎病毒传播在日本北海道戊型肝炎的发生中起重要作用，戊型肝炎病毒基因型和潜在疾病的存在影响戊型肝炎的严重程度。(C)2005 Wiley-Liss，Inc
Hepatitis E in industrialized countries has not been well studied. To define the possible risk factors for transmission of hepatitis E virus (HEV) and for the severe form of hepatitis E in Japan, we investigated the clinical and virological characteristics of hepatitis E in 32 patients who contracted the mild (n = 23) or severe form (n = 9) of domestically acquired hepatitis E between 1996 and 2004 in Hokkaido, where hepatitis E is most prevalent in Japan. Nine patients with the severe form of hepatitis E included two patients with fulminant hepatitis E and seven patients who were diagnosed with severe acute hepatitis in which hepatic encephalopathy did not appear during the course of the illness despite low plasma prothrombin activity (= 20 mg/dl). At least 25 patients (78%) had consumed uncooked or undercooked pig liver and/or intestine 1-2 months before the onset of hepatitis E. When compared with the seven patients with HEV genotype 3, the 25 patients with HEV genotype 4 had a higher peak alanine aminotransferase (ALT) level (P = 0.0338) and a lower level of lowest prothrombin activity (P = 0.0340). The severe form of hepatitis E was associated with the presence of an underlying disease (56% [5/9] vs. 17% [4/23], P = 0.0454). The study suggests that zoonotic food-borne transmission of HEV plays an important role in the occurrence of hepatitis E in Hokkaido, Japan, and that the HEV genotype and the presence of an underlying disease influence the severity of hepatitis E. (C) 2005 Wiley-Liss, Inc