Xia J, Liu L, Wang L, Zhang Y, Zeng H, Liu P, Zou Q, Wang L, Zhuang H
Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
J Viral Hepat. 2015 Oct;22(10):850-7. doi: 10.1111/jvh.12406. Epub 2015 Mar 11.
A high mortality rate of approximately 20% in pregnant women with hepatitis E has been reported in previous studies. However, other studies showed no difference between pregnant and nonpregnant women in the severity of hepatitis E. To determine the effects of HEV infection on pregnancy, we successfully established HEV infection in six pregnant rabbits (PR) and six nonpregnant rabbits (NPR) with a rabbit HEV isolate, taking three PR and one NPR without HEV infection as controls. Tests for HEV RNA by RT-PCR, anti-HEV antibodies by ELISA and HEV antigen via immunohistochemistry and histopathology were carried out. Two of six infected PR miscarried and three of the remaining four PR died which may be attributed to severe liver necrosis caused by HEV infection. Moreover, vertical transmission was found to be associated with the replication of HEV in placenta, indicated by the presence of HEV RNA and antigen in placenta from the infected PR. Our findings strongly suggest that HEV infection could lead to adverse outcomes in pregnancy and vertical transmission, suggesting the necessity for pregnant women at risk of HEV infection to be vaccinated.
先前的研究报告称，戊型肝炎孕妇的死亡率约为20%。然而，其他研究表明，戊型肝炎的严重程度在孕妇和非孕妇之间并无差异。为了确定戊型肝炎病毒（HEV）感染对妊娠的影响，我们用一株兔HEV分离株成功感染了6只孕兔（PR）和6只非孕兔（NPR），并将3只未感染HEV的PR和1只未感染HEV的NPR作为对照。通过逆转录聚合酶链反应（RT-PCR）检测HEV RNA，通过酶联免疫吸附测定（ELISA）检测抗HEV抗体，并通过免疫组织化学和组织病理学检测HEV抗原。6只感染的PR中有2只流产，其余4只PR中有3只死亡，这可能归因于HEV感染导致的严重肝坏死。此外，在感染的PR的胎盘中发现了HEV RNA和抗原，表明垂直传播与HEV在胎盘中的复制有关。我们的研究结果强烈表明，HEV感染可导致妊娠不良结局和垂直传播，这表明有必要对有HEV感染风险的孕妇进行疫苗接种。
