A 5-year Single-Center Experience of Hepatitis E Virus Infection During Pregnancy

Karna, Rahul; Hazam, Rajib Kishore; Borkakoti, Jayanta; Kumar, Ashok

doi:10.1016/j.jceh.2019.09.003

Cited by 11 publications

(12 citation statements)

References 17 publications

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“…However, outcomes are much worse for pregnant women: HEV mortality can exceed 50%, particularly if acquired in the third trimester. Several large cohort studies from India have demonstrated that pregnant women with HEV are both more likely to develop fulminant hepatic failure (FHF) and more likely to die from it ( 237 – 240 ). A 2019 systematic review including a total of 1,338 pregnant women with hepatitis E showed a 45% risk of fulminant hepatic failure, a median maternal CFR of 26% and a median fetal CFR of 33%.…”

Section: Acute Viral Infections That Cause Severe Maternal Diseasementioning

confidence: 99%

Innate Immune Responses to Acute Viral Infection During Pregnancy

et al. 2020

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Section: Acute Viral Infections That Cause Severe Maternal Diseasementioning

confidence: 99%

Innate Immune Responses to Acute Viral Infection During Pregnancy

et al. 2020

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“…HEV was the cause of ALF in 145 of the 244 pregnant women, 100 of the 329 nonpregnant women, and 97 of the 420 men. In another study, HEV was the cause of ALF in 102 of the 139 pregnant women as against 111 of the 181 nonpregnant women ( p < 0.03) [ 137 ]. Kar et al studied 100 patients with ALF, 50 of whom were pregnant and another 50 nonpregnant women of childbearing age.…”

Section: Hev-alf and Pregnancymentioning

confidence: 99%

Hepatitis E and Pregnancy: An Unholy Alliance Unmasked from Kashmir, India

Khuroo

2021

Viruses

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The adverse relationship between viral hepatitis and pregnancy in developing countries had been interpreted as a reflection of retrospectively biased hospital-based data collection by the West. However, the discovery of hepatitis E virus (HEV) as the etiological agent of an epidemic of non-A, non-B hepatitis in Kashmir, and the documenting of the increased incidence and severity of hepatitis E in pregnancy via a house-to-house survey, unmasked this unholy alliance. In the Hepeviridae family, HEV-genotype (gt)1 from genus Orthohepevirus A has a unique open reading frame (ORF)4-encoded protein which enhances viral polymerase activity and viral replication. The epidemics caused by HEV-gt1, but not any other Orthohepevirus A genotype, show an adverse relationship with pregnancy in humans. The pathogenesis of the association is complex and at present not well understood. Possibly multiple factors play a role in causing severe liver disease in the pregnant women including infection and damage to the maternal-fetal interface by HEV-gt1; vertical transmission of HEV to fetus causing severe fetal/neonatal hepatitis; and combined viral and hormone related immune dysfunction of diverse nature in the pregnant women, promoting viral replication. Management is multidisciplinary and needs a close watch for the development and management of acute liver failure. (ALF). Preliminary data suggest beneficial maternal outcomes by early termination of pregnancy in patients with lower grades of encephalopathy.

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“…There have been several investigations to understand the effects of HEV infection on maternal and fetal health; however, definitive conclusions cannot be made due to contradictory observations among the different studies (87)(88)(89)(90). In a recent 5years single-center study in India, 1,088 patients (550 pregnant and 538 non-pregnant controls) were evaluated to understand the course and severity of HEV infection during pregnancy (91). All the patients were confirmed for either acute viral hepatitis (AVH) or acute liver failure (ALF) through clinical examination and biochemical investigations.…”

Section: Risk To the Mothermentioning

confidence: 99%

SARS-CoV-2 in Pregnancy: Fitting Into the Existing Viral Repertoire

Rajput¹,

Sharma

2021

Front. Glob. Womens Health

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The risk of viral infection during pregnancy is well-documented; however, the intervention modalities that in practice enable maternal-fetal protection are restricted by limited understanding. This becomes all the more challenging during pandemics. During many different epidemic and pandemic viral outbreaks, worse outcomes (fetal abnormalities, mortality, preterm labor, etc.) seem to affect pregnant women than what has been evident when compared to non-pregnant women. The condition of pregnancy, which is widely understood as “immunosuppressed,” needs to be re-understood in terms of the way the immune system works during such a state. The immune system gets transformed to accommodate and facilitate fetal growth. The interference of such supportive conversion by viral infection and the risk of co-infection lead to adverse fetal outcomes. Hence, it is crucial to understand the risk and impact of potent viral infections likely to be encountered during pregnancy. In the present article, we review the effects imposed by previously established and recently emerging/re-emerging viral infections on maternal and fetal health. Such understanding is important in devising strategies for better preparedness and knowing the treatment options available to mitigate the relevant adverse outcomes.

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A 5-year Single-Center Experience of Hepatitis E Virus Infection During Pregnancy

Cited by 11 publications

References 17 publications

Innate Immune Responses to Acute Viral Infection During Pregnancy

Innate Immune Responses to Acute Viral Infection During Pregnancy

Hepatitis E and Pregnancy: An Unholy Alliance Unmasked from Kashmir, India

SARS-CoV-2 in Pregnancy: Fitting Into the Existing Viral Repertoire

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