Seroprevalence of Antibodies to Hepatitis E Virus Among Pregnant Women

Abstract

Background: Hepatitis E virus (HEV) infection is a major public health problem in developing countries, which could progress to an acute self-limited hepatitis. Young adults and middle-aged people are more likely to be infected than children and elderly persons. The disease is usually mild in general population; severe infection is more seen among pregnant women and leads to a high rate of mortality in this population. Objectives: This study aimed to assess seroprevalence of HEV infection and related risk factors among pregnant women referred to Fatemieh Hospital in Hamadan, Iran. Patients and Methods: A total of 1050 pregnant women were included in this prospective cross-sectional study, conducted from 2010 to 2011. Anti-HEV specific IgG was measured with ELISA method. A questionnaire containing research purposes was also fulfilled for each participant. Results:The mean age of pregnant women was 27.2 ± 5.6 years. The overall seroprevalence of anti-HEV was 7.4%. There was a significant association between anti-HEV seropositivity and age (P < 0.001), degree of education (P = 0.017), number of household members (P = 0.002), siblings (P = 0.005), and parities (P = 0.007). However, no significant relationship was observed between positive anti-HEV and variables such as place of residence, occupation, history of animal contacts, agricultural activities, type of drinking water, and the method of washing vegetables (P > 0.05). Conclusions: According to the results, 92.6% of pregnant women were anti-HEV negative. However, there is no available effective vaccine for its prevention in human yet. Therefore, education about environmental and personal hygiene before and during pregnancy may be helpful for decreasing the rate of HEV infection in this high risk population.

Prevalence, risk factors and molecular evaluation of hepatitis E virus infection among pregnant women resident in the northern shores of Persian Gulf, Iran

“…Furthermore, we found a significant association between HEV seroprevalence and the number of pregnancy, so that anti-HEV seroprevalence was significantly higher among those women with more than three pregnancies. This finding is consistent with studies done by Mamani et al [ 16 ] and Tabarraei et al [ 17 ], while some other studies do not support this finding [ 14 , 22 , 25 ].…”

“…HEV seroprevalence of 6.3% reported in the present study is higher than those reported among pregnant women in different parts of Iran, 3.6% in Urmia [ 14 ] and 5.26% in Ahvaz [ 15 ], but lower than those reported in Hamadan (7.4%) [ 16 ] and Gorgan (7.4%) [ 17 ]. Overall, the prevalence of HEV among pregnant women varies from 3.6% to 7.4% in different regions of Iran.…”

Epidemiology of Hepatitis E in Pregnant Women and Children in Iran: A General Overview

“…46 – 48 Compared to the other endemic countries, 50 – 52 the seroprevalence of HEV infection among Iranian pregnant women is low. 45 , 47 , 48 In addition, there is a considerable difference in rate of HEV seroprevalence between Iran and neighbouring countries such as the United Arab Emirates (20.0%) 53 and India (33.67%); 50 meanwhile, it is similar to that reported for Turkey (7.0%). 54…”

“…Considering the adverse effects of HEV infection on pregnancy outcomes, prevention strategies, appropriate precautions and training programs regarding the possible routes of exposure to HEV as well as routine screening for HEV infection before and during pregnancy are needed to reduce the occurrence and adverse consequences of HEV infection in the pregnant population. 46 , 47 Overall, the importance of HEV infection during pregnancy is underestimated in Iran and there are no current data on the rate of maternal mortality in Iran.…”

Seroprevalence of hepatitis E virus infection in pregnant women: a systematic review and meta-analysis

“…After screening by title and abstract, we selected 15 studies for the meta-analysis. [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] Articles were excluded on the basis of the following: review articles (n=251); book chapters (n=381); topics other than HEV infection in pregnant women such as HEV infection among blood donors, animal studies, duplicate, published before 2015, insufficient information (n=5193); and other languages (n=11) as described in Figure 2. The 15 studies reported on 8337 subjects, of which 1175 subjects were non-pregnant women and were subtracted from the total sample size.…”