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Hepatitis E Virus and Pregnancy

Dr. Nargis.Hepatitis E virus (HEV) is a major public health concern in the developing countries: Prevent exposure to HEV during pregnancy.

By Dr. Nargis Begum;

Hepatitis E virus (HEV) is a major public health concern in the developing countries. HEV infection in pregnant women is quite common and unfortunately fatal in the third trimester. The mortality rate due to HEV-induced hepatitis during pregnancy is as high as 15-20 per cent. WHO estimates that hepatitis E caused approximately 44 000 deaths in 2015 (accounting for 3.3% of the mortality due to viral hepatitis).

A hospital based study was conducted to determine the subclinical HEV infection in pregnant primigravidae women and it was found that the exposure to HEV during pregnancy was higher in urban (slum areas) than rural population (Indian J Med Res. 2009 Dec;130(6):709-13). Therefore adherence to preventive measures by pregnant women, especially when started early during gestation, is extremely useful in decreasing the maternal and prenatal mortality and morbidity associated with HEV infection during pregnancy. Since the virus is transmitted via the faecal-oral route, principally via contaminated water, the following preventive measures are recommended for pregnant women. Hands must be washed thoroughly with soap and warm water after defecation and urination (i.e. after using the toilet). Handwashing with soap and warm water before preparing, serving or eating food and washing vegetables and fruits thoroughly with clean water before being use are also highly useful measures.

Apart from this, using boiled water for drinking and brushing teeth, consuming hygienically and freshly prepared warm food at home, intake of homemade fresh fruit juices, avoiding drinking untreated ground water, avoiding eating left-overs and stale food and raw or uncooked meat and fish are also important. One must remember to stick to a diet rich in nutrients, antioxidants and vitamins at all times.

Immunization:
Two recombinant hepatitis E vaccines have been developed from HEV genotype 1, by GlaxoSmithKline and Xiamen Innovax Biotech. These vaccines have demonstrated short-term efficacy in clinical trials. One of the two vaccines is presently being used in China since 2012 under the commercial name Hecolin. However, the long-term efficacy of this hepatitis E vaccine is yet to be determined
http://www.nejm.org/doi/full/10.1056/NEJMoa1406011

 

Dr. Nargis Begum, Ph.D (Molecular Virology), Maulana Azad Medical College, New Delhi, India.

July 28, 2017

References:

Indian J Med Res. 2009 Dec;130(6):709-13.
Seroprevalence of subclinical HEV infection in pregnant women from north India: a hospital based study. https://www.ncbi.nlm.nih.gov/pubmed/20090131

 

 

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