Clinical features of sporadic hepatitis E virus infection in pregnant women in Shanghai, China. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Zhang, Fan; Wang, Jiefei; Cheng, Jilin; Zhang, Xiaohong; He, Qiyu; Zhaochao, Liang; Shu, Jingyi; Yan, Li; Wang, Ling; Wang, Lin; Zhang, Jianliang
• Is Part Of: Journal of infection. Volume 84:Issue 1(2022)
• Page Start: 64
• Page End: 70
• Publication Date: 2022-01
• Subjects: Hepatitis E -- Hepatitis E virus -- Clinical features -- Pregnant women; HEV Hepatitis E Virus -- ALT alanine aminotransferase -- AST aspartate aminotransferase -- ALP alkaline phosphatase -- GGT γ-glutamyl transpeptidase -- TBil total bilirubin -- DBiL direct bilirubin -- ALB albumin -- TBA total bile acids -- INR international normalized ratio -- PTA prothrombin activity; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2021.11.004
• Languages: English
• ISSNs: 0163-4453

Abstract

Summary: Objectives: Hepatitis E virus (HEV) infection causes high mortality in pregnant women of developing regions during large outbreaks. The aim of this study was to investigate the clinical features of HEV-infected pregnant women in Shanghai, China where the epidemiology of HEV has shifted from large outbreaks to the sporadic form. Methods: Clinical data of 516 pregnant and nonpregnant child-bearing age women diagnosed with HEV infection during 2009–2020 was collected at the Shanghai Public Health Clinical center. Patients' data were analysed for clinical features and laboratory parameters accordingly. Results: Most of the hospitalized HEV-infected pregnant women (85.23%, 127/149) showed no obvious clinical symptoms and the disease outcome was generally benign with no liver failure or maternal mortality observed in the patients. By comparison, fewer (37.21%, 32/86) of the HEV-infected nonpregnant women were asymptomatic, and five cases (5.81%, 5/86) of liver failure were observed among them. The levels of serum alanine aminotransferase, aspartate aminotransferase, total bilirubin (TBiL), direct bilirubin (DBiL) and total bile acids (TBA) were significantly higher ( P < 0.05) in nonpregnant women than those of the pregnant women. We found 42.99% (46/107) births had adverse foetal/neonatal outcome. Mothers who presented with adverse foetal/neonatal outcome showed higher ( P < 0.05) serum TBiL, DBiL and TBA levels than those without. Conclusion: We found that the clinical features of sporadic HEV infection in pregnant women in Shanghai, China are generally mild and no maternal mortality occurred. However foetal/neonatal adverse outcomes including preterm births and stillbirths were observed in HEV-infected pregnant women. Highlights: Clinical features in HEV-infected pregnant women in Shanghai, China are generally mild and no maternal mortality occurs. In 42.99% of births adverse foetal/neonatal outcomes seen include preterm births and stillbirths. Anti-HEV IgG may be passed from mother to child. Universal vaccination of women of child-bearing age should be considered in the future to avoid HEV-associated adverse foetal/neonatal outcomes in pregnant women.