目的:分析不同人群合并感染戊型肝炎病毒(HEV)的感染率,探索不同人群合并感染HEV的差异性,为临床不同人群合并感染HEV进行早期防治提供参考依据,旨在减少HEV感染造成的危害。方法:根据纳入、排除标准收集血清标本共计805份,其中正常人群血清标本200份,妊娠期女性血清标本298份,慢性肝病患者血清标本281份(其中慢性乙肝156份、慢性丙肝24份、其余慢性肝病101份),艾滋病(HIV)感染者血清标本26份,通过ELISA(捕获法)对HEV特异性IgG抗体进行检测。结果:HIV感染者组较正常人群组抗HEV-IgG阳性率高(P＜0.05),HIV感染者人群中抗HEV-IgG阳性组年龄较阴性组大(P＜0.05)。慢性肝病人群中抗HEV-IgG阳性组年龄大于阴性组(P＜0.05)。慢性肝病人群抗HEV-IgG阳性率高于正常人群(P＜0.05)。年龄分组讨论,大于40岁组中,慢性肝病组的抗HEV-IgG阳性率高于正常人群(P＜0.05)。结论: HIV感染者、慢性肝病患者是感染HEV的高风险人群,较正常人群的HEV感染率明显上升,且合并感染HEV的风险会随年龄的增长而升高。对不同人群合并感染HEV的感染率进行研究,促进多学科联合,有效筛查HEV感染人群,为HEV早期防治,合理化治疗提供参考依据。
Objective: To analyze the infection rate of hepatitis E virus (HEV) in different populations, and to explore the difference of HEV co-infection in different populations, so as to provide reference for early prevention and treatment of HEV co-infection in different populations, and to reduce the harm caused by HEV infection. Methods: A total of 805 serum samples were collected according to the inclusion and exclusion criteria, including 200 serum samples from normal population, 298 serum samples from pregnant women, 281 serum samples from patients with chronic liver disease (156 samples of chronic hepatitis B, 24 samples of chronic hepatitis C, 101 samples of other chronic liver diseases), and 26 serum samples from HIV-infected patients. HEV-specific IgG antibodies were detected by ELISA (capture method). Results: The positive rate of anti-HEV-IgG in HIV infected group was higher than that in normal group (P＜0.05). The age of anti-HEV-IgG positive group in HIV infected group was older than that in negative group (P＜0.05). The age of anti-HEV-IgG positive group was older than that of negative group (P＜0.05). The positive rate of anti-HEV-IgG in chronic liver disease population was higher than that in normal population (P＜0.05). In the group over 40 years old, the positive rate of anti-HEV-IgG in chronic liver disease group was higher than that in normal population (P＜0.05). Conclusion: HIV-infected patients and patients with chronic liver disease are high-risk groups for HEV infection, and the HEV infection rate is significantly higher than that of the normal population, and the risk of co-infection with HEV increases with age. Therefore, it is necessary to study the infection rate of HEV co-infection in different populations, promote multidisciplinary cooperation, effectively screen HEV-infected populations, and provide reference for early prevention and rational treatment of HEV.
[1] Khuroo MS. Study of an epidemic of non-A, non-B hepatitis. Possibility of another human hepatitis virus distinct from post-transfusion non-A, non-B type[J]. Am J Med, 1980, 68(6):818-824.
[2] Nimgaonkar I, Ding Q, Schwartz RE, et al. Ploss A. Hepatitis E virus: advances and challenges[J]. Nat Rev Gastroenterol Hepatol, 2018, 15(2):96-110.
[3] Fierro NA. Advances in Hepatitis E Virus[J]. Pathogens,2023, 12(8):987.
[4] Songtanin B, Molehin AJ, Brittan K,et al. Hepatitis E Virus Infections: Epidemiology, Genetic Diversity, and Clinical Considerations[J]. Viruses, 2023, 15(6):1389.
[5] 李兰娟, 中国戊型肝炎研究协助组(CCSHE), 中国医师协会感染科医师分会,等. 中国戊型病毒性肝炎院内筛查管理流程专家共识(2023年版)[J] .临床肝胆病杂志, 2023, 39(4):785-794.
[6] Di Bartolomeo S, Carubbi F, Cipriani P. Hepatitis E Virus and rheumatic diseases: what do rheumatologists need to know[J]. BMC Rheumatol, 2020, 4:51.
[7] von Felden J, Alric L, Pischke S, et al. The burden of hepatitis E among patients with haematological malignancies: A retrospective European cohort study[J]. J Hepatol, 2019, 71(3):465-472.
[8] Bhatti TK, Singal AK, Kwo PY. Viral Hepatitis and Acute-on-Chronic Liver Failure[J]. Clin Liver Dis, 2023, 27(3):617-630.
[9] Wang Y, Liu H, Liu S, et al. Incidence, predictors and prognosis of genotype 4 hepatitis E related liver failure: A tertiary nested case-control study[J]. Liver Int, 2019, 39(12):2291-2300.
[10] Wang Y, Liu H, Jiang Y, et al. Poor Outcomes of Acute Hepatitis E in Patients With Cirrhotic Liver Diseases Regardless of Etiology[J]. Open Forum Infect Dis, 2020, 7(4):ofaa107.
[11] 钟曼华,王静月,黄缘. 妊娠合并戊型肝炎研究进展 [J]. 临床肝胆病杂志, 2023, 39 (10): 2448-2453.
[12] 宋欢,丁红云,赵真真,等. 戊型肝炎防治进展 [J]. 中国肝脏病杂志(电子版), 2023, 15 (3): 23-27.
[13] Ma JX, Liu YY, Li Q, et al. Study on the safety and immunogenicity of simultaneous vaccination on both hepatitis E and hepatitis B vaccines[J].Zhonghua Liu Xing Bing Xue Za Zhi, 2019, 40(4):451-456.
[14] 陈雅梦,尹玲,张宏伟,等. 湖北省HIV感染人群戊型肝炎流行病学调查 [J]. 中华疾病控制杂志, 2019, 23 (4): 392-396.
[15] ]Rivero-Juarez A, Lopez-Lopez P, Pineda JA, et al. Limited Value of Single Sampling for IgM Antibody Determination as a Diagnostic Approach for Acute Hepatitis E Virus Infection[J]. Microbiol Spectr, 2021, 9(1):e0038221.
[16] 石神鉴,刘江艺,潘欢欢,等. 2013—2022年泉州市戊型病毒性肝炎流行病学特征分析 [J]. 中国初级卫生保健, 2023, 37 (9): 39-41.
[17] 梁灵芝,黄昌,黄文秀,等. 2006-2022年南宁市戊型病毒性肝炎流行病学特征 [J]. 中国疫苗和免疫, 2024, 30 (1): 25-28.
[18] 富小飞,刘砚清,胡洁,等. 2005-2021年嘉兴市甲型病毒性肝炎和戊型病毒性肝炎流行特征分析 [J]. 预防医学, 2023, 35 (9): 737-740.
[19] Kilonzo SB, Wang YL, Jiang QQ, et al. Superinfective Hepatitis E Virus Infection Aggravates Hepatocytes Injury in Chronic Hepatitis B[J]. Curr Med Sci, 2019, 39(5):719-726.
[20] 何英利. 慢性肝病合并戊型肝炎病毒感染的研究现状及对策 [J]. 中国实用内科杂志, 2023, 43 (5): 375-377.
[21] 肖红霞,张守德,周昇,等. 丙型肝炎病毒感染人群的戊型肝炎流行特征分析 [J]. 医学动物防制, 2018, 34 (5): 417-419, 422.
[22] 东瑞,黄丽丽,王洁. 戊型肝炎重症化与慢性化免疫学机制研究进展 [J]. 南京医科大学学报(自然科学版), 2023, 43 (10): 1464-1469.
[23] Peron JM, Larrue H, Izopet J, et al. The pressing need for a global HEV vaccine[J]. J Hepatol, 2023, 79(3):876-880.
[24] Bhatnagar N, Prakash S, Ramakrishna V, et al. Molecular characterisation of Hepatitis E virus isolates from north India[J]. Indian J Med Microbiol, 2022, 40(1):91-95
[25] 钱忠瑶. 戊型肝炎病毒感染孕妇的流行病学调查及致不良妊娠结局机制的初步研究[D].昆明:昆明理工大学, 2022.
