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戊型肝炎病毒针对特殊人群的疫苗接种策略及研究空白

Vaccination Strategies and Research Gaps in Hepatitis E Virus for Special Populations.

作者信息

Wang Meng, Duan Binwei, Liu Mengcheng, Zhang Yuxuan, Wu Feng, Li Guangming, Ouyang Yabo

机构信息

Department of General Surgery Center, Beijing YouAn Hospital, Capital Medical University, Beijing Institute of Hepatology, Beijing 100069, China.

Clinical Center for Liver Cancer, Capital Medical University, Beijing 100069, China.

出版信息

Vaccines (Basel). 2025 Jun 9;13(6):621. doi: 10.3390/vaccines13060621.

Abstract

BACKGROUND

Hepatitis E virus (HEV) infection poses a significant health risk across diverse demographic groups, particularly among pregnant women, immunocompromised individuals, patients with chronic liver disease, and the elderly. The global epidemiology of HEV reveals distinct patterns of prevalence, transmission, and disease severity among these populations, necessitating targeted vaccination strategies. The licensing of the Hecolin (HEV 239) vaccine offers promise, but gaps in clinical trial data and varying immune responses in high-risk groups challenge its widespread applicability.

SCOPE

This review synthesizes data on HEV's epidemiology, discusses the susceptibility of vulnerable populations, evaluates the efficacy and safety of HEV 239, and highlights the urgent need for clinical research tailored to these groups. Key findings underscore the complexity of vaccine response influenced by immunological, physiological, and environmental factors. Additionally, potential advancements in vaccine technology, including the development of broad-spectrum vaccines and innovative delivery systems, are discussed as future directions.

STRATEGIES

Addressing regulatory, economic, and logistical barriers remains crucial for effective HEV vaccination programs. A multidisciplinary approach integrating public health policy, rigorous clinical evaluations, and collaborative frameworks is essential to ensure equitable access to HEV vaccination, ultimately improving health outcomes on a global scale.

摘要

背景

戊型肝炎病毒(HEV)感染对不同人群构成重大健康风险,尤其是孕妇、免疫功能低下者、慢性肝病患者和老年人。HEV的全球流行病学显示,这些人群在流行率、传播方式和疾病严重程度方面存在不同模式,因此需要有针对性的疫苗接种策略。Hecolin(HEV 239)疫苗的获批带来了希望,但临床试验数据的差距以及高危人群中不同的免疫反应对其广泛应用提出了挑战。

范围

本综述综合了关于HEV流行病学的数据,讨论了易感人群的易感性,评估了HEV 239的疗效和安全性,并强调了针对这些人群开展临床研究的迫切需求。主要研究结果强调了受免疫、生理和环境因素影响的疫苗反应的复杂性。此外,还讨论了疫苗技术的潜在进展,包括广谱疫苗的开发和创新的给药系统,作为未来的发展方向。

策略

解决监管、经济和后勤障碍对于有效的HEV疫苗接种计划仍然至关重要。采用综合公共卫生政策、严格临床评估和协作框架的多学科方法,对于确保公平获得HEV疫苗接种至关重要,最终在全球范围内改善健康状况。

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