2003, Número 3
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Rev Biomed 2003; 14 (3)
Virus de la hepatitis E
Quintana-González A
Idioma: Español
Referencias bibliográficas: 191
Paginas: 165-189
Archivo PDF: 100.63 Kb.
RESUMEN
El virus de la hepatitis E (VHE), posible nuevo integrante de la familia
Caliciviridae, es un virus no envuelto, con un ARN de simple cadena y de sentido positivo, el cual posee tres marcos de lectura abiertos y superpuestos que codifican para las proteínas estructurales y no estructurales necesarias para su ciclo replicativo. Se trasmite predominantemente por vía fecal oral, a través de aguas contaminadas y es uno de los seis principales virus capaces de causar un cuadro clínico de hepatitis viral en el hombre. Además, provoca cuadros de hepatitis fulminante en mujeres embarazadas, alcanzando hasta un 20% de letalidad. Presenta una distribución geográfica mundial, aunque sólo es altamente endémico en el subcontinente Indio, en el centro y el sudeste de Asia, Medio Oriente y parte de África, donde se han reportado las más grandes e importantes epidemias causadas por este agente viral. Luego de varios años de estudio sobre la epidemiología molecular del VHE, se ha planteado la existencia de cepas epidémicas y no epidémicas, siendo estas últimas las causantes de los casos esporádicos encontrados en países desarrollados. Las cepas del VHE aisladas en humanos tienen una estrecha relación genética con cepas halladas en cerdos, ratas y pollos, sugiriendo que la hepatitis E es una enfermedad de posible transmisión zoonótica. La variedad antigénica entre las cepas no parece ser tan amplia como la encontrada genéticamente. Sin embargo, los candidatos vacunales en desarrollo no muestran claramente una seroprotección contra todos los genotipos del VHE hasta hoy descritos. Mientras tanto, el buen tratamiento de las aguas albañales y potables, son los métodos más efectivos para el control de las epidemias desatadas por el VHE. Este artículo trata de resumir los conocimientos actuales acerca de la estructura molecular y biologica del virus, así como la epidemiología, el diagnóstico de la infección, y muestra cómo se comporta la incidencia de la hepatitis E en diferentes regiones del mundo.
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