Hepatitis E virus and fulminant hepatitis--a virus or host-specific pathology?
Hepatitis E virus and fulminant hepatitis--a virus or host-specific pathology?
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DOI：
10.1111/liv.12629
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Simmonds P
中科院分区：
文献类型：
--
作者：
Smith DB;Simmonds P
暴发性肝炎是戊型肝炎病毒感染的罕见结果。最近的一些报告表明，病毒变异是疾病进展的重要决定因素。严格检查戊型肝炎病毒感染后暴发性肝炎发展的病毒特异性因素的证据。收集了已发表的戊型肝炎病毒分离株的序列信息，并使用统计学检验进行分析，以确定病毒多态性与疾病结局之间的关系。暴发性肝炎已被报道感染所有四种戊型肝炎病毒基因型后，感染人类，包括基因型1，3和4内的多个系统发育谱系。对来自共同感染源的个体的病毒序列进行分析，未发现任何与暴发性肝炎进展相关的常见替换。对先前报道的病毒替换和暴发性肝炎之间的关联进行重新分析表明，这些可能是抽样偏差的结果。宿主特异性因素，而不是病毒基因型，变异或特定的替代似乎是负责暴发性肝炎的发展。
Fulminant hepatitis is a rare outcome of infection with hepatitis E virus. Several recent reports suggest that virus variation is an important determinant of disease progression. To critically examine the evidence that virus-specific factors underlie the development of fulminant hepatitis following hepatitis E virus infection. Published sequence information of hepatitis E virus isolates from patients with and without fulminant hepatitis was collected and analysed using statistical tests to identify associations between virus polymorphisms and disease outcome. Fulminant hepatitis has been reported following infection with all four hepatitis E virus genotypes that infect humans comprising multiple phylogenetic lineages within genotypes 1, 3 and 4. Analysis of virus sequences from individuals infected by a common source did not detect any common substitutions associated with progression to fulminant hepatitis. Re-analysis of previously reported associations between virus substitutions and fulminant hepatitis suggests that these were probably the result of sampling biases. Host-specific factors rather than virus genotype, variants or specific substitutions appear to be responsible for the development of fulminant hepatitis.