Intrahepatic and extrahepatic clinical manifestations and treatment progress for hepatitis type E.
10.3760/cma.j.cn501113-20230301-00088
- VernacularTitle:戊型肝炎的肝内外临床表现与治疗进展
- Author:
Hong Yang LIU
1
;
Jing Min ZHAO
1
Author Information
1. The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China.
- Publication Type:Journal Article
- Keywords:
Clinical manifestation;
Hepatitis E;
Prognosis;
Treatment
- MeSH:
Humans;
Antiviral Agents/therapeutic use*;
Ribavirin/therapeutic use*;
Hepatitis, Chronic/drug therapy*;
Hepatitis E virus;
Liver Diseases/drug therapy*;
Liver Failure/drug therapy*
- From:
Chinese Journal of Hepatology
2023;31(5):471-476
- CountryChina
- Language:Chinese
-
Abstract:
Hepatitis type E virus (HEV) is one of the main causes of acute hepatitis globally and has thus gained attention as a public health issue. The diverse clinical manifestations of hepatitis type E are typically acute and self-limiting with mild symptoms, but populations with underlying liver disease or immunocompromised patients can have severe and chronic symptoms. Severity and chronicity can arise and manifest as fulminant hepatitis, chronic hepatitis, or even hepatic failure. HEV infection-induced hepatic failure (acute-on-chronic liver failure), based on the different backgrounds of chronic liver disease, is a clinical phenotype of severe HEV infection that requires attention. In addition, HEV infection can exhibit extrahepatic clinical manifestations of multi-system and organ involvement like neurological diseases (Guillain-Barré syndrome), renal diseases (membranous/membranous proliferative glomerulonephritis, cryoglobulinemia), and blood diseases (thrombocytopenia). At home or abroad, there are no antiviral drugs approved, particularly for HE treatment. Since most acute HE can resolve spontaneously, no special treatment is required clinically. However, in patients with severe or chronic HE, ribavirin (RBV) monotherapy and/or pegylated interferon-combination therapy have achieved certain antiviral effects. Combined small-molecule drugs and RBV have been attempted to treat HEV, but high-level evidence-based treatment is still lacking. Thus, new, highly effective anti-HEV drugs are clinical priorities to address these concerns. Severe and chronic HEV infections' clinical phenotype, early detection, mechanism, intervention, and outcome need additional study.
