Abstract
The hepatitis E virus is an emergent infectious agent that affects both developing and developed countries. This hepatotropic virus causes a wide spectrum of clinical scenarios; from an acute auto limited viral hepatitis E to a fulminant hepatic failure. Due to hormonal and immunological reasons, pregnant women are at increased risk of adverse outcomes of this disease related to higher maternal and fetal morbimortality. The main treatment for hepatitis E infections in pregnant women is merely supportive, making prevention in this population the main goal. This article will review the epidemiology, clinical scenarios and obstetric complications associated with the hepatitis virus infection during pregnancy. In addition, the progesterone and immunological system role in this disease will be discussed.
Keywords
References
2. Pérez-Gracia M, Suay-García B, Mateos-Lindemann M. Hepatitis E and pregnancy: current state. Reviews in Medical Virology [Internet]. 2017 [citado 22 Febrero 2019];27(3):e1929. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1002/rmv.1929
3. Wedemeyer H, Pischke S, Manns M. Pathogenesis and Treatment of Hepatitis E Virus Infection. Gastroenterology [Internet]. 2012 [citado 18 Febrero 2019];142(6):1388-1397.e1. Disponible en: https://www.gastrojournal.org/article/S0016-5085(12)00227-2/fulltext
4. Khuroo M, Khuroo M. Hepatitis E: an emerging global disease - from discovery towards control and cure. Journal of Viral Hepatitis [Internet]. 2015 [citado 19 Febrero 2019];23(2):68-79. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jvh.12445
5. Teshale E, Hu D, Holmberg S. The Two Faces of Hepatitis E Virus. Clinical Infectious Diseases [Internet]. 2010 [citado 17 Febrero 2019];51(3):328-334. Disponible en: https://academic.oup.com/cid/article/51/3/328/307805
6. Borkakoti J, Hazam R, Mohammad A, Kumar A, Kar P. Does high viral load of hepatitis E virus influence the severity and prognosis of acute liver failure during pregnancy?. Journal of Medical Virology [Internet]. 2012 [citado 24 Febrero 2019];85(4):620-626. Disponible en: https://www.jcehepatology.com/article/S0973-6883(13)00258-2/pdf
7. Hakim M, Wang W, Bramer W, Geng J, Huang F, de Man R et al. The global burden of hepatitis E outbreaks: a systematic review. Liver International [Internet]. 2016 [citado 23 Febrero 2019];37(1):19-31. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27542764
8. Aggarwal R. Clinical presentation of hepatitis E. Virus Research [Internet]. 2011 [citado 17 Febrero 2019];161(1):15-22. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0168170211001109
9. Bouthry E, Benachi A, Vivanti A, Letamendia E, Vauloup-Fellous C, Roque-Afonso A. Autochthonous Hepatitis E during Pregnancy, France. Emerging Infectious Diseases [Internet]. 2018 [citado 1 Marzo 2019];24(8):1586-1587. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056134/
10. Tabatabai J, Wenzel J, Soboletzki M, Flux C, Navid M, Schnitzler P. First case report of an acute hepatitis E subgenotype 3c infection during pregnancy in Germany. Journal of Clinical Virology [Internet]. 2014 [citado 20 Febrero 2019];61(1):170-172. Disponible en: https://www.sciencedirect.com/science/article/pii/S1386653214002248
11. Patil T, Deshpande A, Gulhane R, Bansod Y, Shinde N, Patil M. Clinical profile, maternal and fetal outcomes of acute hepatitis e in pregnancy. Annals of Medical and Health Sciences Research [Internet]. 2014 [citado 18 Febrero 2019];4(8):133. Disponible en: https://www.ajol.info/index.php/amhsr/article/view/113611
12. Kamar N, Dalton H, Abravanel F, Izopet J. Hepatitis E Virus Infection. Clinical Microbiology Reviews [Internet]. 2014 [citado 24 Febrero 2019];27(1):116-138. Disponible en: https://cmr.asm.org/content/27/1/116.short
13. Bose P, Das B, Kumar A, Gondal R, Kumar D, Kar P. High viral load and deregulation of the progesterone receptor signaling pathway: Association with Hepatitis E-related poor pregnancy outcome. Journal of Hepatology [Internet]. 2011 [citado 20 Febrero 2019];54(6):1107-1113. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0168827810009645
14. Kumar A, Devi S, Kar P, Agarwal S, Husain S, Gupta R et al. Association of cytokines in hepatitis E with pregnancy outcome. Cytokine [Internet]. 2014 [citado 24 Febrero 2019];65(1):95-104. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S104346661300714X?via%3Dihub
15. Lhomme S, Marion O, Abravanel F, Chapuy-Regaud S, Kamar N, Izopet J. Hepatitis E Pathogenesis. Viruses [Internet]. 2016 [citado 28 Febrero 2019];8(8):212. Disponible en: https://www.mdpi.com/1999-4915/8/8/212
16. Kmush B, Ali H, Engle R, West K, Shaikh S, Christian P et al. The Association of Cytokines and Micronutrients with Hepatitis E Virus Infection During Pregnancy and the Postpartum Period in Rural Bangladesh. The American Journal of Tropical Medicine and Hygiene [Internet]. 2016 [citado 1 Marzo 2019];94(1):203-211. Disponible en: http://www.ajtmh.org/docserver/fulltext/14761645/94/1/203.pdf?expires=1552068690&id=id&accname=guest&checksum=B29D68E7AEEBE641F08128BA56CB137F
17. Khuroo M, Kamali S, Jameel S. Vertical transmission of hepatitis E virus. The Lancet [Internet]. 1995 [citado 16 Febrero 2019];345(8956):1025-1026. Disponible en: https://www.sciencedirect.com/science/article/pii/S0140673695907610
18. Khuroo M, Kamili S, Khuroo M. Clinical course and duration of viremia in vertically transmitted hepatitis E virus (HEV) infection in babies born to HEV-infected mothers. Journal of Viral Hepatitis [Internet]. 2009 [citado 18 Febrero 2019];16(7):519-523. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2893.2009.01101.x
19. Krain L, Labrique A, Atwell J, Nelson K. Fetal and Neonatal Health Consequences of Vertically Transmitted Hepatitis E Virus Infection. The American Journal of Tropical Medicine and Hygiene [Internet]. 2014 [citado 24 Febrero 2019];90(2):365-370. Available from: https://www.ajtmh.org/content/journals/10.4269/ajtmh.13-0265
20. Rivero-Juarez A, Frias M, Rodriguez-Cano D, Cuenca-López F, Rivero A. Isolation of Hepatitis E Virus From Breast Milk During Acute Infection: Table 1. Clinical Infectious Diseases [Internet]. 2016 [citado 2 Marzo 2019];62(11):1464.2-1464. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27025819
21. Chaudhry S, Verma N, Koren G. Hepatitis E infection during pregnancy. Canadian Family Physician [Internet]. 2015 [citado 22 Febrero 2019];61(7):607-608. Disponible en: http://www.cfp.ca/content/61/7/607
22. Joshi S, Arankalle V. Enhanced humoral response in pregnant mice immunized with liposome encapsulated recombinant neutralizing epitope protein of Hepatitis- E virus. Virology Journal [Internet]. 2015 [citado 24 Febrero 2019];12(1). Disponible en: https://virologyj.biomedcentral.com/articles/10.1186/s12985-015-0302-8
23. Li S, Zhao Q, Wu T, Chen S, Zhang J, Xia N. The development of a recombinant hepatitis E vaccine HEV 239. Human Vaccines & Immunotherapeutics [Internet]. 2015 [citado 3 Marzo 2019];11(4):908-914. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25714510
24. Goel A, Aggarwal R. Advances in hepatitis E – II: Epidemiology, clinical manifestations, treatment and prevention. Expert Review of Gastroenterology & Hepatology [Internet]. 2016 [citado 1 Marzo 2019];10(9):1065-1074. Disponible en: https://www.tandfonline.com/doi/full/10.1080/17474124.2016.1185365?scroll=top&needAccess=true