警惕输血引起的慢性戊型肝炎

Alert on transfusion-transmitted chronic hepatitis E

戊型肝炎主要是HEV经粪-口传播引起的病毒性肝炎,然而近年来陆续报道了一些通过输血传播的病例。虽然通常情况下戊型肝炎为急性自限性疾病,但患者如处于免疫抑制状态(如器官移植、肿瘤化疗或HIV感染等),感染HEV后会发展为慢性肝炎,并有可能迅速发展为肝纤维化和肝硬化。由于这些患者常常需要多次输血,更加大了感染HEV的风险。本文总结了全球献血员的HEV流行情况、经输血传播HEV的病例及免疫缺陷患者感染HEV后的危害等,提示应警惕输血引起的慢性戊型肝炎。

Although the main mode of HEV transmission is by the fecal-oral route, transmission through blood transfusion has been documented as well in recent years. Generally, HEV causes an acute self-limiting hepatitis, however, immunosuppressed patients, such as organ transplant recipients, cancer patients receiving chemotherapy or patients with HIV infection, may progress to chronic hepatitis, or even rapidly progress to fibrosis and cirrhosis. As those patients always need blood transfusion, they are at increased risk for being infected with HEV. In this review, the authors summarize the worldwide seroprevalence of HEV in blood donors, list the reported cases of transfusion transmission of HEV infection, describe the severity of HEV infection in immunocom-promised patients, and suggest keeping alert on transfusion-transmitted chronic hepatitis E.