Abstract: The clinical progress and outcome of hepatitis E virus（HEV） infected patients with immune insufficiency is an emerging issue in recent years.In patients with normal immune function，HEV infection usually manifests as acute self-limiting hepatitis.However，in solid organ transplant patients，HEV infection was susceptible to switch to chronic and could even rapidly develop into significant hepatic fibrosis and cirrhosis.Compared to the kidney transplant recipients with HEV infection，liver transplant recipients with HEV infection might be more likely to develop into chronic hepatitis，hepatic fibrosis，and cirrhosis.HEV infection was also easy to become chronic in patients with human immunodeficiency virus（HIV） infection and hematological malignancy，but further research is needed on whether infection or exposure of HEV can promote its to the progress of hepatic fibrosis or cirrhosis. The solid organ transplant recipients might be more likely to be infected by HEV than HIV infected patients and hematological malignancy patients，however，all of them with HEV infection had high risk of chronic infection development.In the immunocompromised patients，HEV infection requires early detection，early diagnosis and early treatment，and its diagnosis mainly dependents on the detection of HEV-RNA in serum or faeces.The detected HEV genotypes in chronic HEV infection patients are genotype HEV3 at present.

Key words: Hepatitis E virus；Autoimmune insufficiency；Fibrosis, liver；Liver cirrhosis

摘要： 免疫功能不全患者戊型肝炎病毒（HEV）感染的临床发展和结局是近年来比较关注的新问题。在免疫功能正常的人群中，HEV感染通常表现为急性自限性，但是，实体器官移植受者HEV感染易转为慢性，甚至有可能迅速发展为明显肝纤维化和肝硬化，其中肝移植受者感染HEV后可能较肾移植受者更易发展为慢性肝炎、肝纤维化和肝硬化；人类免疫缺陷病毒（HIV）感染者、血液系统恶性肿瘤患者HEV感染亦易转为慢性，但对于HEV感染或暴露是否会促进其向肝纤维化或肝硬化的进展尚需要进一步研究。实体器官移植受者可能较HIV感染者、血液系统恶性肿瘤患者更易感染HEV，但三者感染HEV后均有发展为慢性感染的高风险。在免疫功能不全人群中，HEV感染需早发现、早诊断、早治疗，其诊断主要依赖于血清或粪便HEV-RNA检测，目前慢性HEV感染者检测出的HEV基因型均为HEV3。

关键词: 戊型肝炎病毒, 自身免疫功能不全, 纤维化, 肝, 肝硬化