Infection with the hepatitis E virus (HEV) is the leading cause of acute viral hepatitis worldwide. With an estimated number of 20 million infections and 3.3 million symptomatic cases, accounting for 3.3% of viral hepatitis-related deaths annually, HEV poses a major public health threat.1 2 Transmission of HEV occurs mainly by the faecal-oral route in low-income and middle-income countries due to poor sanitation. Here, endemic outbreaks and sporadic cases are mainly caused by infection with genotypes 1 and 2 (HEV-1 and HEV-2), which exclusively infect humans. In developed countries, only sporadic cases of HEV infection are reported, which are attributed mostly to zoonotic genotypes 3 and 4 (HEV-3 and HEV-4) infections. As swine represents the main reservoir for HEV-3, transmission is usually linked to the consumption of undercooked pork products.3 However, due to the lack of specific antiviral therapy, thorough risk assessment is crucial to protect vulnerable populations. Especially solid organ transplant recipients are a high-risk population, since HEV-3 infections in immunocompromised individuals are frequently associated with a chronic course of disease and fast progression to cirrhosis.3 Although lung transplant recipients receive strong immunosuppressive therapy, research on chronic hepatitis E (CHE) in this population is limited due to the low number of reported cases.4 Lung …

中文翻译：

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猪源性胰酶药物对戊型肝炎病毒跨物种传播的潜在风险


戊型肝炎病毒 (HEV) 感染是全世界急性病毒性肝炎的主要原因。据估计，每年有 2000 万感染者和 330 万有症状病例，占病毒性肝炎相关死亡的 3.3%，HEV 构成了重大公共卫生威胁。1 2 HEV 传播主要通过粪便-口腔途径在低收入人群中传播。收入和中等收入国家由于卫生条件差。这里的地方性暴发和散发病例主要是由基因型1和2（HEV-1和HEV-2）感染引起的，它们专门感染人类。在发达国家，仅报告了HEV感染的散发病例，这主要归因于人畜共患基因型3和4（HEV-3和HEV-4）感染。由于猪是 HEV-3 的主要宿主，传播通常与食用未煮熟的猪肉产品有关。3然而，由于缺乏特定的抗病毒治疗，彻底的风险评估对于保护弱势群体至关重要。特别是实体器官移植受者是高危人群，因为免疫功能低下个体的 HEV-3 感染通常与慢性病程和快速进展为肝硬化有关。3 尽管肺移植受者接受强免疫抑制治疗，但对慢性戊型肝炎的研究由于报告病例数较少，（CHE）在该人群中的应用有限。4 肺……