Brazil is the fifth largest country in the world with diverse socioeconomic and sanitary conditions, also being the fourth largest pig producer in the world. The aim of the present systematic review was to collect and summarize all HEV published data from Brazil (from 1995 to October 2020) performed in humans, animals, and the environment, in a One Health perspective. A total of 2173 papers were retrieved from five search databases (LILACs, Mendeley, PubMed, Scopus, and Web of Science) resulting in 71 eligible papers after application of exclusion/inclusion criteria. Data shows that HEV genotype 3 (HEV-3) was the only retrieved genotype in humans, animals, and environment in Brazil. The South region showed the highest human seroprevalence and also the highest pig density and industry, suggesting a zoonotic link. HEV-1 and 2 were not detected in Brazil, despite the low sanitary conditions of some regions. From the present review we infer that HEV epidemiology in Brazil is similar to that of industrialized countries (only HEV-3, swine reservoirs, no waterborne transmission, no association with low sanitary conditions). Hence, we alert for the implementation of HEV surveillance systems in swine and for the consideration of HEV in the diagnostic routine of acute and chronic hepatitis in humans.

中文翻译：

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巴西戊型肝炎病毒的系统评价：人类-动物-环境三位一体的一种健康方法

巴西是世界第五大国，社会经济和卫生条件多样化，也是世界第四大生猪生产国。本系统评价的目的是从一个健康的角度收集和总结巴西（1995 年至 2020 年 10 月）在人类、动物和环境中进行的所有 HEV 公布数据。从五个搜索数据库（LILACs、Mendeley、PubMed、Scopus 和 Web of Science）中检索到 2173 篇论文，在应用排除/纳入标准后产生了 71 篇符合条件的论文。数据显示，HEV 基因型 3 (HEV-3) 是巴西人类、动物和环境中唯一检索到的基因型。南部地区的人类血清阳性率最高，猪密度和产业也最高，表明存在人畜共患病的联系。尽管一些地区的卫生条件较差，但在巴西并未检测到 HEV-1 和 2。根据本综述，我们推断巴西的 HEV 流行病学与工业化国家相似（只有 HEV-3、猪水库、无水传播、与低卫生条件无关）。因此，我们提醒在猪中实施 HEV 监测系统，并在人类急性和慢性肝炎的诊断程序中考虑 HEV。