Hepatitis E Virus — A Potential Threat to Pregnancy
Journal Title: Journal of Enam Meical College - Year 2014, Vol 4, Issue 3
Abstract
Hepatitis E virus has become the most frequent and leading cause of acute hepatitis in developing countries.1 The disease was first recognized in the Indian subcontinent in 1950s following contamination of drinking water during a flood. Then a large number of people developed jaundice. Although it was initially believed to be an outbreak of hepatitis A, a substantial number of cases in adults and the high risk of death from fulminant hepatitis in pregnant women made that speculation unlikely.2 HEV has been responsible for major outbreaks of acute hepatitis in the developing countries of Asia, Africa and Latin America over the last 50 years.3 The virus is transmitted enterically from person to person through contaminated water and uncooked food resulting in hepatitis epidemics or sporadic cases. The highest incidence of sporadic cases in developing countries is observed in 15–35 years age group; in developed countries, individuals older than 45 years have the highest incidence.4 In the industrialized countries, hepatitis E is considered as an emerging disease of global importance and has been reported in a number of developed countries. HEV has a peculiar trait of progression to chronic hepatitis E in immunocompromised patients and it has an alarming course in pregnant women in certain geographical regions of the world. Severe form of HEV is known to be more pronounced in pregnant women. Even though most of the described cases of acute hepatic failure associated with HEV during pregnancy had a favorable clinical course, some cases of fulminant liver failure and death are described. Studies from various developing countries have shown that the incidence of HEV infection in pregnancy is high and a significant proportion of pregnant women can progress to fulminant hepatitis with a mortality rate varying from 30–100%5,6, whereas in men and non-pregnant women, the disease is usually self-limited and has a case fatality rate of less than 0.1%. The high mortality rate in pregnancy has been thought to be secondary to the associated hormonal (estrogen and progesterone) changes during pregnancy and consequent immunological changes.
Authors and Affiliations
Rosy Sultana
Keywords
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- EP ID EP36202
- DOI https://doi.org/10.3329/jemc.v4i3.20939
- Views 297
- Downloads 0
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