Hepatitis E virus infection and its associated adverse feto-maternal outcomes among pregnant women in Qinhuangdao, China

Li, Manyu; Bu, Qiuning; Gong, Weibin; Li, Haomin; Wang, Lin; Li, Shuangshuang; Sridhar, Siddharth; Woo, Patrick C. Y.

doi:10.1080/14767058.2019.1582630

Cited by 28 publications

(39 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study among pregnant women in Qinhuangdao, China, showed that the positivity rates of anti-HEV IgM and/or anti-HEV IgG were significantly higher in the third trimester than in the first and second trimesters [61], consistent with previous reports. Among these pregnant women, the HEV strain exclusively identified in those with a history of HEV infection was HEV-4 [61], which seemingly coincides with the fact that HEV-4 is now the most prevalent strain in China. However, considering that HEV-1 and HEV-3 have also been reported in China [62,63], more studies are needed to clarify the HEV genotypes prevalent among pregnant women in China and the correlation between HEV genotypes and maternal and fetal outcomes.…”

Section: Epidemiology Of Hev Infection In Pregnancysupporting

confidence: 88%

“…Furthermore, besides the factors related to sex, age structure, and sampling errors, the differences in the specificity and sensitivity of HEV detection attributable to different laboratory diagnostic techniques should also be considered [55,60]. A recent study among pregnant women in Qinhuangdao, China, showed that the positivity rates of anti-HEV IgM and/or anti-HEV IgG were significantly higher in the third trimester than in the first and second trimesters [61], consistent with previous reports. Among these pregnant women, the HEV strain exclusively identified in those with a history of HEV infection was HEV-4 [61], which seemingly coincides with the fact that HEV-4 is now the most prevalent strain in China.…”

Section: Epidemiology Of Hev Infection In Pregnancysupporting

confidence: 82%

See 1 more Smart Citation

Hepatitis E virus infection during pregnancy

Xia

2020

Virol J

View full text Add to dashboard Cite

Background: Hepatitis E virus (HEV) generally causes self-limiting viral hepatitis. However, in pregnant women, HEV infection can be severe and has been associated with up to 30% mortality in the third trimester. Additionally, HEV infection in pregnancy is also associated with high rates of preterm labor and vertical transmission. Main body: HEV is now recognized as a global health problem in both developing and industrialized countries. HEV can be transmitted via the fecal-oral route, zoonotic route, and blood transfusion route. An altered immune status, hormonal levels, and viral factors may be related to the severity of the disease. Currently, no established treatment is available for HEV in pregnant women. A Chinese vaccine has been demonstrated to be protective against HEV in the general population and seems to be safe in pregnancy; however, its safety and efficacy in a large population of pregnant women remain to be determined. Conclusion: This review summarizes the current knowledge about HEV infection during pregnancy and focuses on the epidemiology, clinical manifestations, mechanisms underlying severe liver injury, and management and prevention of HEV infection during pregnancy. Considering that HEV infection during pregnancy may result in poor outcomes, screening for and monitoring HEV infection early in pregnancy should be taken into account. In addition, a better understanding of the pathogenesis will help to develop potential treatment strategies targeting HEV infection in pregnancy.

show abstract

Section: Epidemiology Of Hev Infection In Pregnancysupporting

confidence: 88%

Section: Epidemiology Of Hev Infection In Pregnancysupporting

confidence: 82%

Hepatitis E virus infection during pregnancy

Xia

2020

Virol J

View full text Add to dashboard Cite

show abstract

“…Vertical transmission is one of the main transmission routes for HEV that causes premature births and prenatal mortality 9 , 10 . Mother-to-child transmission was observed in 46.09% (59/128) of HEV IgM-positive mothers 6 .…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have reported that gt1 or gt2 HEV during pregnancy causes acute liver failure and maternal death 9 . In China, adverse pregnancy outcomes, including preterm births, premature rupturing of membranes, and abortion, have been reported in genotype 4 HEV-infected pregnant women 10 , 11 . However, the pathogenesis of gt4 HEV in pregnant women is unclear.…”

Section: Introductionmentioning

confidence: 99%

Vertical transmission of hepatitis E virus in pregnant rhesus macaques

Hao

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Hepatitis E virus (HEV) is the major pathogen of viral hepatitis. HEV causes high mortality in pregnant women. Its infection during pregnancy usually leads to fulminant hepatic failure, spontaneous abortions, premature delivery, or stillbirth. Vertical transmission of HEV has been reported, but the pathogenesis during pregnancy remains largely elusive. Pregnant rhesus macaques were infected with HEV to explore the pathogenesis of genotype 4 HEV infection during pregnancy. Active HEV infections were established with shedding viruses in the feces and blood, and elevated liver enzymes. Notably, higher viral titers and longer durations of HEV infection were found in HEV-infected pregnant rhesus macaques than in non-pregnant macaques. Premature delivery and fetal death occurred in one of the HEV-infected pregnant rhesus macaques. HEV RNA was detected in the liver, spleen, kidneys, and intestines of the dead fetus. This result strongly indicated vertical HEV transmission from mother to fetus. Maternal-transferred antibodies were observed in one of the babies with poor protection. The expressions of interferon-stimulated genes (ISGs) related to HEV infection were completely different between pregnant and non-pregnant rhesus macaques. During pregnancy, impaired innate immune responses, reduced progesterone levels, and shifts in immune states may aggravate HEV infection and result in adverse pregnancy outcomes.

show abstract

“…Typically, HEV infection is a mild self-limiting disease with low case fatality rate, but pregnant women, particularly in the second and third trimester, are more susceptible to HEV and severe clinical outcomes. (288) Proposed factors contributing to risk in pregnancy include HEV genotype 1 (with varying replication efficiency at the maternal-fetal placenta interface), (289,290) folate or other nutritional deficiencies, (291) and immunologic changes in pregnancy. (292) Acute HEV is responsible for an estimated 3,000 stillbirths worldwide annually, (293) with fetal and neonatal mortality rates likely influenced by the severity of maternal illness.…”

Section: Hepatitis Ementioning

confidence: 99%