74 Role of Genetic Alteration in MTHFR Gene and Homo-Cysteine Levels as Critical Factors Influencing Hev Related Pregnancy Outcome

Baruah, Bhaskar; Bose, Purabi Deka; Ray, Charubrata; Bose, Muthiah; Saikia, Anjan; Deka, Manab; Bose, Sujoy

doi:10.1016/s0168-8278(12)60088-9

Cited by 2 publications

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“…Possible explanations for the more severe course in pregnant women are hormonal, genetic and immunological changes during pregnancy [12,84,85]. It has been suggested that a reduced expression of the progesterone receptor or a mutation of the human methylenetetrahydrofolate reductase (MTHFR) gene might be associated with development of fulminant hepatitis E in pregnant women [84,85]. The clinical course and pathophysiological aspects of HEV infections during pregnancy are covered in more detail elsewhere in this issue, too.…”

Section: Acute Hev-infection In Pregnant Womenmentioning

confidence: 99%

Acute Hepatitis E: Two Sides of the Same Coin

Hartl

Wehmeyer

Pischke

2016

Viruses

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The relevance of acute hepatitis E virus (HEV) infections has been underestimated for a long time. In the past, HEV infection had been interpreted falsely as a disease limited to the tropics until the relevance of autochthonous HEV infections in the Western world became overt. Due to increased awareness, the incidence of diagnosed autochthonous HEV infections (predominantly genotype 3) in industrialized countries has risen within the last decade. The main source of infections in industrialized countries seems to be infected swine meat, while infections with the tropical HEV genotypes 1 and 2 usually are mainly transmitted fecal-orally by contaminated drinking water. In the vast majority of healthy individuals, acute HEV infection is either clinically silent or takes a benign self-limited course. In patients who develop a symptomatic HEV infection, a short prodromal phase with unspecific symptoms is followed by liver specific symptoms like jaundice, itching, uncoloured stool and darkened urine. Importantly, tropical HEV infections may lead to acute liver failure, especially in pregnant women, while autochthonous HEV infections may lead to acute-on-chronic liver failure in patients with underlying liver diseases. Immunosuppressed individuals, such as transplant recipients or human immunodeficiency virus (HIV)-infected patients, are at risk for developing chronic hepatitis E, which may lead to liver fibrosis and cirrhosis in the long term. Importantly, specific treatment options for hepatitis E are not approved by the regulation authorities, but off-label ribavirin treatment seems to be effective in the treatment of chronic HEV-infection and may reduce the disease severity in patients suffering from acute liver failure.

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Section: Acute Hev-infection In Pregnant Womenmentioning

confidence: 99%

Acute Hepatitis E: Two Sides of the Same Coin

Hartl

Wehmeyer

Pischke

2016

Viruses

View full text Add to dashboard Cite

show abstract

“…A fulminant course of hepatitis E is more frequent in pregnant women and patients with a previous history of liver disease (20 to 25%) (1,3). In the former group, fulminant disease may be explained by increased expression of progesterone receptors or mutations in the MTHFR gene (17,18). MTHFR (methylenetetrahydrofolate reductase) is an enzyme involved in numerous metabolic processes, and deficiency of MTHFR in pregnant women is associated with spina bifida.…”

Section: Acute Hepatitis Ementioning

confidence: 99%