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Prevalence and clinical features of hepatitis E virus infection in pregnant women: A large cohort study in Inner Mongolia, China - 11/10/20

Doi : 10.1016/j.clinre.2020.08.012 
Xiao-xia Ma a, 1, Yunpeng Ji a, b, c, 1, Li Jin a, Zulqarnain Baloch a, De-rong Zhang a, Yijin Wang d, Qiuwei Pan a, c, , Zhongren Ma a,
a Key Laboratory of Biotechnology and Bioengineering of State Ethnic Affairs Commission, Biomedical Research Center, Northwest Minzu University, Lanzhou, China 
b Department of Genetics, Inner Mongolia Maternal and Child Care Hospital, Hohhot, Inner Mongolian Autonomous Region, China 
c Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands 
d Department of Pathology and Hepatology, The 5th Medical Center, Chinese PLA General Hospital, Beijing, China 

Corresponding author at: Northwest Minzu University, Room Na-100, Lanzhou, 730030, China.Northwest Minzu UniversityRoom Na-100Lanzhou730030China⁎⁎Corresponding author at: Erasmus MC, Room Na-1005, Wytemaweg 80, NL-3015 CN, Rotterdam, The Netherlands.Erasmus MC, Room Na-1005, Wytemaweg 80RotterdamNL-3015 CNThe Netherlands
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 11 October 2020

Highlights

6% of past HEV infection and 0.6% of recent/ongoing infection in Chinese pregnant women
Ongoing/recent infection appears to associate with adverse maternal and neonatal outcomes.
Future research is warranted to further confirm our findings in large populations in China.

Le texte complet de cet article est disponible en PDF.

Abstract

Background and aim

Hepatitis E virus (HEV) infection causes severe maternal and fetal outcomes in pregnant women. These patients are exclusively from resource-limited regions with genotype 1 HEV infection, but not from western countries with genotype 3 prevalence. Since the circulating strains in China have evolved from the waterborne genotype 1 to the zoonotic genotype 4 HEV in the past decades, this study aims to evaluate the prevalence and clinical features of HEV infection in a large cohort of pregnant women in Inner Mongolia, China.

Methods

A total of 3278 pregnant women who visited the Inner Mongolia Maternal and Child Care hospital during 2018 were enrolled. Serum samples were examined for anti-HEV IgG and anti-HEV IgM antibodies using ELISA. Demographic information, results of clinical biochemical tests, maternal and neonatal outcomes were collected.

Results

Among the recruited 3278 pregnant women, 6.0% were anti-HEV IgG antibody positive, 0.3% were anti-HEV IgM antibody positive and 0.3% were positive for both anti-HEV IgG and anti-HEV IgM antibodies. HEV viral RNA was not detected. Pregnant women with recent/ongoing HEV infection indicated by anti-HEV IgM positivity have slightly higher ALT level, and potential risk of developing hyperlipidemia, preterm delivery and neonatal jaundice.

Conclusions

These findings indicated that HEV infection is associated with a possible increase in adverse maternal, fetal and neonatal outcomes in our cohort. Thus, the burden of HEV infection in pregnant women in China appears distinct from resource-limited regions and western countries. Nevertheless, future studies are required to confirm and extend our findings.

Le texte complet de cet article est disponible en PDF.

Abbreviations : HEV, FHF, AST, ALT

Keywords : Hepatitis E virus, Pregnant women, Sero-Prevalence, Outcomes, Risk factors, China


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© 2020  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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