Epidemiologie virové hepatitidy E

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Autoři: A. Kasem; K. Azeem; J. Vlčková; S. Zatloukalová; L. Štěpánek; Z. Kyselý; H. Kollárová
Působiště autorů: Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
Vyšlo v časopise: Epidemiol. Mikrobiol. Imunol. 68, 2019, č. 4, s. 176-182
Kategorie: Souhrnná sdělení, původní práce, kazuistiky

Souhrn

Hepatitida E patří mezi hlavní problémy veřejného zdraví. Odhaduje se, že každý rok na hepatitidu E ve světě zemře přibližně 44 000 osob. Virus hepatitidy E je nejčastější příčinou akutní virové hepatitidy na světě. Zatím bylo popsáno 7 genotypů viru hepatitidy E, z nichž pouze 4 mohou způsobit onemocnění člověka.

Genotypy 1 a 2 jsou obligátními lidskými patogeny, k přenosu dochází fekálně-orální cestou a prostřednictvím kontaminované vody. Jsou hlavními příčinami epidemické a endemické akutní hepatitidy v rozvojových zemích v důsledku špatných hygienických podmínek. Naopak ve vyspělých zemích prevalují genotypy 3 a 4, které jsou zoonotického původu a jsou přenášeny alimentárně a přímým kontaktem s infikovaným zvířetem. U genotypů 3, 4 byl popsán i přenos krví, krevními produkty a tkáněmi z infikovaných osob nebo zvířat, také byl popsán přenos z matky na dítě. Většina infekcí HE probíhá klinicky asymptomaticky, ale průběh se může lišit od self-limiting onemocnění až po fulminantní selhání jater. Byly popsány i extrahepatální projevy infekce virem hepatitidy E.

Prevence infekce virem hepatitidy E se zaměřuje především na hygienická opatření, jako jsou bezpečnost pitné vody a sanitace lidských odpadů. Důraz by měl být kladen i na stravovací zvyklosti, kulinární úpravu a také na sledování distribuce zoonotických rezervoárů.

Vakcína proti virové hepatitidě E je dostupná pouze v Číně, chrání pouze proti genotypu 4 a nejsou důkazy o zkřížené ochraně i proti jiným genotypům.

Klíčová slova:

epidemiologie – hepatitida E – VHE – rizikové faktory – prevence

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