Role of hepatitis E virus in sporadic cases of acute and fulminant hepatitis in an endemic area (Chad)

Role of hepatitis E virus in sporadic cases of acute and fulminant hepatitis in an endemic area (Chad)
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DOI:
10.4269/ajtmh.1998.58.330
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发表时间:
1998-03-01
影响因子:
3.3
通讯作者:
Roue, R
Roue, R
中科院分区:
医学4区
文献类型:
--
作者:
Coursaget, P;Buisson, Y;Roue, R

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1993年,在乍得的恩贾梅纳地区,41名急性或暴发性肝炎患者和86名对照患者参加了一项散发性、急性和暴发性肝炎的研究。急性B型肝炎9例(22%),急性戊型肝炎27例(66%)。未观察到急性甲型肝炎,10%的患者有丙型肝炎病毒(HCV)感染的血清学标志物。在4名患者(10%)中观察到双重急性B和戊型肝炎,在16名患者(39%)中观察到急性HEV感染与慢性B型肝炎表面抗原携带相关。来自乍得的关于HBV的流行病学调查结果表明,这些患者患有未确诊的HBV所致慢性肝病,并伴有叠加MEV复制引起的急性恶化。此外,很明显,在发展中国家,只有最严重的肝炎病例出现在医院环境中,其中很大一部分与HBV和HEV的重叠感染有关。对照组中22%的患者有HEV抗体阳性。这一观察结果以及在乍得观察到HEV流行和散发病例的事实表明,HEV在该国是高度地方性的。
Forty-one patients with acute or fulminant hepatitis and 86 control patients were entered into a study of sporadic, acute, and fulminant hepatitis in the N'Djamena area of Chad in 1993. Acute hepatitis B was diagnosed in nine (22%) patients and acute hepatitis E in 27 (66%) patients. No acute hepatitis A was observed and 10% of the patients had serologic markers of hepatitis C virus (HCV) infection. Dual acute hepatitis B and E were observed in four patients (10%) and acute HEV infection was associated with chronic hepatitis B surface antigen carriage in 16 (39%). Epidemiologic findings concerning HBV from Chad suggest that these patients had undiagnosed chronic liver disease due to HBV, with acute deterioration caused by superimposed MEV replication. Moreover, it is obvious that In developing countries only the most severe cases of hepatitis are seen in hospital settings and a large proportion of them are related to superinfection with HBV and HEV. Antibody to HEV was observed in 22% of the control patients. This observation and the fact (hat epidemic and sporadic cases of HEV are observed in Chad indicates that HEV is highly endemic in this country.