Infection for the Hepatitis E virus in pregnant women of Córdoba, Argentina

Abstract

Background: The hepatitis E virus (HEV) is an important and poorly studied pathogen of worldwide distribution that causes enteric hepatitis. The HEV infection in humans is usually self-limited. However, cases of severe fulminant hepatitis have been reported in pregnant women and immunosuppressed patients. In Argentina, serological evidence of human HEV infection has been described in different geographical regions. In Córdoba, HEV prevalence of 4.4% in general population, 7.3% in HIV + individuals, 5.8% in solid organ transplant patients and 10.2% in hemodialysis patients have been documented. Besides, RNA-HEV detections have been performed and genotype 3 was detected. The aim of this research was to describe the circulation of HEV in pregnant women from Córdoba, know if there were symptomatic cases, analyse risk factors related to the infection, and compare the findings with the non-pregnant control group Methods and materials: A total of 202 serum samples from pregnant women (52 prospective and 150 retrospective samples), and 155 samples from non-pregnant women with the same ages (control group) from Córdoba were analysed for IgG anti-HEV detection. Positive samples were tested for IgM anti-HEV and RNA-HEV. Two samples from pregnant women with acute hepatitis were also analysed for HEV detection. Results: The seropositivity of IgG anti-HEV obtained for pregnant women was 8.4%, higher than the 2.6% obtained in the control group, and association between pregnancy and HEV infection was found (p = 0.023). There were no differences between seropositivity rates according to the trimester of pregnancy, although differences were found among age groups, with the higher prevalence in pregnant women younger than 25 years (16.7%, p = 0.032). From the IgG anti-HEV + patients, 2 presented IgM anti-HEV, although both were asymptomatic. None of these samples were positive for RNA-HEV detection. Conclusion: The present study shows, for the first time, the circulation of HEV in pregnant women from Córdoba, generating data that contributes to improve the surveillance and diagnosis of a virus little known in our environment, and under-diagnosed. These association between pregnancy and HEV infection should alert the local health team to consider this microorganism as an agent of liver disease in pregnant women.