Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide. The systematic use of improved tools for diagnosing and genotyping has completely changed our understanding of the epidemiology and clinical consequences of HEV infection. Most cases of HEV in Europe arise from infected animals such as pigs, wild boar, deer and rabbits. Zoonotic HEV genotypes (HEV genotypes 3-8) are mainly food-borne or transmitted by direct contact, but recent data suggest that infection can also be water-borne or even iatrogenic throught contamined blood products. HEV-3 is the most prevalent genotype in Europe but the geographic distributions of the 3 major clades and subgenotypes (HEV-3abjkchi, HEV-3efg, and HEV-3ra) differ. Most HEV-3 infections are asymptomatic but they can result in severe acute hepatitis in patients with chronic liver disease, chronic hepatitis in immunocompromised patients, and to extra-hepatic manifestations. Despite more frequent reports of symptomatic hepatitis E cases across Europe, systems for monitoring HEV infections vary greatly. Severe HEV-associated illnesses, hospitalizations and deaths are probably underestimated. The seroprevalence and incidence of locally acquired hepatitis E varies between and within European countries and over time. The precise origin of these variations is uncertain but may be linked to environmental factors or the degree to which HEV contaminates the human food chain. Collaborative initiatives such as the establishment of the One Health platform for HEV sequences (HEVnet database) will be very useful for a better understanding of the epidemiology of HEV in Europe and the development of effective prevention strategies.

中文翻译：

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欧洲戊型肝炎病毒感染。

戊型肝炎病毒（HEV）是全球范围内急性病毒性肝炎的最常见原因。系统地使用改进的工具进行诊断和基因分型已完全改变了我们对HEV感染的流行病学和临床后果的理解。在欧洲，大多数HEV病例来自受感染的动物，例如猪，野猪，鹿和兔子。人畜共患性HEV基因型（HEV基因型3-8）主要通过食物传播或通过直接接触传播，但最近的数据表明感染也可以是水传播的，甚至是通过污染的血液制品引起的医源性感染。HEV-3是欧洲最流行的基因型，但3个主要进化枝和亚基因型（HEV-3abjkchi，HEV-3efg和HEV-3ra）的地理分布有所不同。大多数HEV-3感染无症状，但它们可导致患有慢性肝病的患者导致严重的急性肝炎，导致免疫功能低下的患者引起的慢性肝炎以及肝外表现。尽管在欧洲有更多关于有症状的戊型肝炎病例的报道，但用于监测HEV感染的系统却大相径庭。严重的HEV相关疾病，住院和死亡可能被低估了。在欧洲国家之间和之内，随着时间的推移，当地获得的戊型肝炎的血清阳性率和发病率也有所不同。这些变异的确切来源尚不确定，但可能与环境因素或HEV污染人类食物链的程度有关。