Fulminant viral hepatitis and pregnancy in Algeria and France

Nouasria, B.; Aouati, A.; Bernau, Jennifer; Rueff, B; Benhamou, Jean‐Pierre; Gaudebout, C.; Larouzé, Bernard; Dazza, Marie-Christine; Saimot, A. G.; Goudeau, Alain

doi:10.1080/00034983.1986.11812077

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…Studies from the west have shown that AVH has no special predilection to pregnancy and the disease in pregnant women has similar clinical course to those in nonpregnant women [25–30]. In contrast, viral hepatitis in developing countries has increased incidence and severity in pregnancy [12, 14–22]. This may be related to differing aetiologies of AVH and FHF in developed and developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…The epidemiology of sporadic AVH and its association with pregnancy has not been well studied. Most of the studies addressing this issue were done when serological tests for HEV were not available and all patients negative for acute markers of HAV and HBV were classified as non‐A, non‐B hepatitis [14–21]. In fact, only about one half of such cases are aetiolologically related to HEV and remaining cases are caused by unknown putative viral agents, hepatitis non‐A‐E (HNAE) [19].…”

Section: Introductionmentioning

confidence: 99%

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Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy*

Khuroo

Kamili²

2003

Journal of Viral Hepatitis

284

208

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Hepatitis E causes large-scale epidemics in endemic areas. The disease, during epidemics, has increased incidence and severity in pregnant women. Sporadic acute viral hepatitis (AVH) is common in endemic areas. The relationship of sporadic AVH and pregnancy has not been well studied. Over a 3-year period we prospectively studied 76 pregnant women and 337 non-pregnant women of childbearing age with sporadic acute viral hepatitis for aetiology, clinical course and outcome of disease. The aetiology in sporadic AVH was hepatitis A virus (HAV) in six (1.5%), hepatitis B virus (HBV) in 62 (15%), hepatitis C virus (HCV) in seven (1.7%), hepatitis D virus (HDV) co-infection in six (1.5%), hepatitis E virus (HEV) in 205 (49.6%), and hepatitis non-A-to-E (HNAE) in 127 (30.7%). Sixty-five (85.5%) pregnant women and 140 (41.5%) nonpregnant women had hepatitis E. The proportion of pregnant women was 31.7% in HEV group and 5.3% in non-HEV group [P < 0.001; OR=8.3 (95%C1 4.2-16.3)]. The prevalence of HEV in pregnant women in first trimester (76.9%), second trimester (88.9%), third trimester (83.8%) and puerperium (100%) did not differ significantly (P=0.09). Forty-seven (61.8%) of the 76 pregnant women developed fulminant hepatic failure (FHF), 69.2% in HEV group and 10% in non-HEV group (P < 0.001). Thirty-four (10.1%) nonpregnant women developed fulminant hepatic failure, 10% in HEV group and 9.7% in non-HEV group (P=0.86). FHF had occurred in four (40%) of 10 patients with HE in first trimester as against 41 (74.5%) of 55 patients in second trimester and beyond (P=0.015). Amongst the major complications of fulminant hepatic failure, cerebral oedema (53.2%) and disseminated intravascular coagulation (21.3%) occurred more often in pregnant women than in nonpregnant women (29.4% and 2.8%; P=0.03 and 0.016, respectively) while infections occurred more often in nonpregnant women (36.1%) than in pregnant women (10.6%; P=0.003). Fifty (61.7%) patients with FHF died [25 (53.2%) pregnant women and 25 (69.5%) nonpregnant women (P=0.06)]. Cerebral oedema and HEV aetiology were independent variables of survival in patients with FHF. Patients with cerebral oedema had worse prognosis and patients with HEV aetiology had best chances of survival. Hence HEV was the most common cause of sporadic AVH in this endemic area. High proportion of pregnant women and increased severity of disease in pregnancy were limited to patients with hepatitis E. Sporadic AVH caused by agents other than HEV did not show any special predilection to or increased severity in pregnancy. FHF in pregnant women caused by HEV was an explosive disease with short pre- encephalopathy period, rapid development of cerebral oedema and high occurrence of disseminated intravascular coagulation and may represent a severe manifestation of a Schwartzmann-like phenomenon.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy*

Khuroo

Kamili²

2003

Journal of Viral Hepatitis

284

208

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“…Nouasria et al. [38] with comparison of FVH (from 15 to 49 years) in 22 Algerian and 77 French pregnant and non-pregnant women found that French pregnant women were remarkably various between the Algerian patients with FVH (45.5% and 24.9%), but not between the French patients (3.9% and 5.8%).…”

Section: Reports Of Incidence In Different Regionsmentioning

confidence: 99%

An update of the incidence of fulminant hepatitis due to viral agents during pregnancy

Seifoleslami

2018

IMAS

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Fulminant hepatitis in pregnant women is one of the major public health issues and remains a challenging clinical problem with extremely high maternal and fetal morbidity and mortality, which, in parallel, viral factors are the most common cause of hepatic disorders and dysfunction during pregnancy that may lead to fulminant hepatic with a fast progression. Therefore, this review helps to inform clinicians about the current status of the incidence of fulminant hepatitis due to viral agents during pregnancy.

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“…These various features are consistent with hepatitis E being newly introduced to the region. By the end of the second decade following the Second World War, endemicity was firmly established : subsequent reports would relate to sporadic disease mainly [115][116][117][118][119][120][121], whereas those related to outbreaks became occasional [118,122,123].…”

Section: Epidemic Escalationsmentioning

confidence: 99%

Fatal outbreaks of jaundice in pregnancy and the epidemic history of hepatitis E

Teo

2012

Epidemiol. Infect.

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SUMMARYSpace–time clustering of people who fall acutely ill with jaundice, then slip into coma and death, is an alarming phenomenon, more markedly so when the victims are mostly or exclusively pregnant. Documentation of the peculiar, fatal predisposition of pregnant women during outbreaks of jaundice identifies hepatitis E and enables construction of its epidemic history. Between the last decade of the 18th century and the early decades of the 20th century, hepatitis E-like outbreaks were reported mainly from Western Europe and several of its colonies. During the latter half of the 20th century, reports of these epidemics, including those that became serologically confirmed as hepatitis E, emanated from, first, the eastern and southern Mediterranean littoral and, thereafter, Southern and Central Asia, Eastern Europe, and the rest of Africa. The dispersal has been accompanied by a trend towards more frequent and larger-scale occurrences. Epidemic and endemic hepatitis E still beset people inhabiting Asia and Africa, especially pregnant women and their fetuses and infants. Their relief necessitates not only accelerated access to potable water and sanitation but also vaccination against hepatitis E.

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Fulminant viral hepatitis and pregnancy in Algeria and France

Cited by 6 publications

References 21 publications

Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy*

Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy*

An update of the incidence of fulminant hepatitis due to viral agents during pregnancy

Fatal outbreaks of jaundice in pregnancy and the epidemic history of hepatitis E

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