Chinese pregnant women in their third trimester are more susceptible to HEV infection

Huang, Fen; Wang, Jue; Yang, Chenchen; Long, Feiyan; Li, Yunlong; Li, Li; Jing, Shenrong; Wang, Huixuan

doi:10.1016/j.bjid.2015.08.009

Cited by 9 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hepatitis E infection causes a high mortality (about 20%) in pregnant women, with an increasingly high incidence and severity in the third trimester of pregnancy [26]. However, the mechanisms for this high morbidity and mortality during pregnancy remains unclear, because of the unavailable animal models.…”

Section: Resultsmentioning

confidence: 99%

Successful Establishment of Hepatitis E Virus Infection in Pregnant BALB/c Mice

Yang

Hao

et al. 2019

Viruses

Self Cite

View full text Add to dashboard Cite

Worldwide, the Hepatitis E virus (HEV) is the main pathogen of acute viral hepatitis, with an extremely high mortality in pregnant women. However, the pathogenesis of HEV infection in pregnant women remains largely unknown. We established an HEV-infected pregnant mice animal model to explore the adverse pregnancy outcomes of HEV infection. Mice were infected with HEV in their early, middle and late stages of pregnancy. HEV RNA was detected in the tissues (liver, spleen, kidney, colon, uterus and placenta) of pregnant mice. HEV antigens were also detected in these tissues of HEV-infected pregnant mice. Miscarriages (7/8, 87.5%) occurred in pregnant mice infected with HEV in the middle of pregnancy. Th1-biased immune status was found in these aborted mice. Vertical transmission was confirmed by HEV replication in the uterus and placenta, as well as in the positive HEV RNA and HEV antigen positive in fetal livers. The successful establishment of HEV infection in pregnant mice is beneficial for further study of HEV pathogenesis, especially the adverse pregnancy outcomes caused by HEV infection.

show abstract

Section: Resultsmentioning

confidence: 99%

Successful Establishment of Hepatitis E Virus Infection in Pregnant BALB/c Mice

Yang

Hao

et al. 2019

Viruses

Self Cite

View full text Add to dashboard Cite

show abstract

“…Homology analysis based on the complete sequence of HEV indicated that these cow HEVs shared 99.2%-99.4% similarity to human HEV isolated from a pregnant woman in Kunming City, in early 2015, (31) and shared 99.5%-99.8% identity with swine HEV isolated in Kunming City in 2010. (32) These results strongly suggest that these HEV isolates prevalent in human, swine, and cows in Yunnan Province probably originated from the same source.…”

Section: High Homology Of Cow/ Milk Hev To Human and Swine Strainsmentioning

confidence: 98%

Excretion of infectious hepatitis E virus into milk in cows imposes high risks of zoonosis

et al. 2016

Self Cite

View full text Add to dashboard Cite

Hepatitis E virus (HEV) represents the main cause of acute hepatitis worldwide. HEV infection in immunocompromised patients involves a high risk for the development of chronic hepatitis. Because HEV is recognized as a zoonotic pathogen, it is currently believed that swine is the primary reservoir. However, this is not sufficient to justify the strikingly high seroprevalence of HEV in both developing and Western countries. Thus, this study aimed to identify new zoonotic sources that bear a high risk of transmission to humans. We collected fecal, blood, and milk samples of cows in a typical rural region of Yunnan Province in southwest China, where mixed farming of domestic animals is a common practice. HEV RNA was quantified by quantitative real-time polymerase chain reaction, and the whole genome was sequenced. HEV infectivity was assessed in rhesus macaques. We found a high prevalence of active HEV infection in cows as determined by viral RNA positivity in fecal samples. Surprisingly, we discovered that HEV is excreted into milk that is produced by infected cows. Phylogenetic analysis revealed that all HEV isolates from cow/ milk belong to genotype 4 and subtype 4h. Gavage with HEV-contaminated raw and even pasteurized milk resulted in active infection in rhesus macaques. Importantly, a short period of boiling, but not pasteurization, could completely inactivate HEV. Conclusion: Infectious HEV-contaminated cow milk is recognized as a new zoonotic source that bears a high risk of transmission to humans; these results call attention to understanding and establishing proper measurement and control of HEV zoonotic transmission, particularly in the setting of mixed farming of domestic animals. (HEPATOLOGY 2016;64:350-359) H epatitis E virus (HEV) is a positive singlestranded RNA virus with four defined genotypes and other newly discovered strains that have not been assigned to these known genotypes. (1) It is the most common cause of acute hepatitis globally. (2) In the Western world, chronic hepatitis has been frequently described in immunocompromised patients. (3) Thus, HEV infection has emerged as a global public health issue with a particularly high mortality rate in pregnant women. (4) Seroprevalence is rather high in the developing world, ranging 30%-80%. Strikingly, it is also very high in Western countries. In the United States, population-based surveys have indicated a seroprevalence of 21% from 1988 to 1994 and 6% from 2009 to 2010. (5) An overall seroprevalence of 22.4% and 27% was found in French (6) and Dutch (7) blood donors, respectively.In the developing world, epidemics of hepatitis E occur periodically and are mainly attributed to genotypes 1 and 2. They account for annually 20 million infections, over 3 million cases with symptomatic diseases, and 70,000 deaths. (8) Fecal contamination of drinking water is a major route of transmission of these two genotypes. (8) In contrast, in developed countries, HEV genotype 3 is predominant and spread by zoonotic transmission.

show abstract

“…HEV infection during pregnancy may lead to fulminant hepatic failure and is associated with a high mortality rate that ranges between 20% and 30% [129,130]. These results are of growing concern, especially in India and other endemic countries.…”

Section: Preventionmentioning

confidence: 99%

Implications of Hepatitis E Virus in Blood Transfusions, Hemodialysis, and Solid Organ Transplants

et al. 2020

View full text Add to dashboard Cite

Hepatitis E Virus (HEV) is emerging as the primary cause of acute viral hepatitis in humans. The virus is commonly transmitted by the fecal–oral route via contaminated water in endemic regions or through the consumption of inadequately cooked swine products or game meats in industrialized regions. HEV genotypes 1 and 2 are predominantly associated with waterborne transmission in developing countries, whereas HEV3 and HEV4 are mainly zoonotically transmitted in industrialized countries. Seroprevalence in populations determined by detecting anti-HEV antibodies and serum HEV RNA is commonly used to analyze the presence of HEV. Although HEV RNA-based detection is now standardized, there is a lack of agreement between the assaying methods used for gathering seroprevalence data. Since 2004, HEV has been considered as a transmissible infectious agent through blood transfusion. Recent seroprevalence studies in European countries indicate an underestimated risk for blood transfusion and hence warrant testing the blood supply. HEV infection is usually self-limiting and spontaneously cleared. However, in about 60% of recipients of solid organ transplants, HEV progresses to chronic hepatitis. Immunosuppressive drugs such as tacrolimus are a major cause of chronic hepatitis and reducing its dosage results in viral clearance in about 30% of patients. In hemodialysis patients, the parenteral route is implicated as an important mechanism of transmission. In this review, we explore the clinical and epidemiological characteristics of various HEV genotypes in blood donors, hemodialysis patients, and transplant recipients.

show abstract

Chinese pregnant women in their third trimester are more susceptible to HEV infection

Cited by 9 publications

References 5 publications

Successful Establishment of Hepatitis E Virus Infection in Pregnant BALB/c Mice

Successful Establishment of Hepatitis E Virus Infection in Pregnant BALB/c Mice

Excretion of infectious hepatitis E virus into milk in cows imposes high risks of zoonosis

Implications of Hepatitis E Virus in Blood Transfusions, Hemodialysis, and Solid Organ Transplants

Contact Info

Product

Resources

About