Hepatitis E HEV And Pregnancy

Infections

Obie Editorial Team

Hepatitis E is a disease caused by the hepatitis E virus HEV which is a non-enveloped, positive sense, single-stranded ribonucleic RNA virus. According to the WHO each year there are 20 million HEV infections, over 3 million acute cases, and over 55,000 HEV related deaths.

How can I get hepatitis E?

Hepatitis E is transmitted through contaminated drinking water, usually the fecal-oral route. Imost people who become infected get better within 4-6 weeks but occasionally a very acute fulminant form of hepatatis E acute liver failure develops which can lead to death. HEV occurs around the world, about 60-65% of cases occur in East and South Asia, in Egypt for example 1/2 of the population above age 5 years tests positive for HEV. 

Symptoms and Signs

The majority of hepatitis E infections are asymptomatic and self limiting. 

Symptoms that may appear after infection include:

  • Jaundice
  • Pain in the right upper abdomen
  • Tender/painful liver
  • Loss of appetite
  • Fever
  • Nausea and Vomiting
Can I test for hepatitis E during pregnancy?

Pregnant women can be tested for hepatitis E, but the test is not part of normal prenatal testing. It involves HEV tests for specific IgM and IgG antibodies in the blood.

What are potential complications with hepatitis E in pregnancy?

Liver failure and fulminant HEV hepatitis occur more frequently during pregnancy. Women infected with HEV are more likely to have greater obbstetric risks and mortality from hepatitis E, which can induce a mortality rate of 20% among pregnant women in their third trimester.

Treatment for hepatitis E during pregnancy

There is no available treatment for HEV and prevention is the best approach against HEV.
Recently, an HEV vaccine has been developed that shows great promise.