Karna Rahul, Hazam Rajib K, Borkakoti Jayanta, Kumar Ashok, Kar Premashis
Department of Medicine, Maulana Azad Medical College, University of Delhi, New Delhi.
Department of Obstetrics and Gynaecology, Maulana Azad Medical College, University of Delhi, New Delhi.
J Clin Exp Hepatol. 2020 Mar-Apr;10(2):135-138. doi: 10.1016/j.jceh.2019.09.003. Epub 2019 Oct 3.
The study was designed to examine the hypothesis whether the course and severity of hepatitis E virus (HEV)-related liver disease is worse during pregnancy.
The prospective study included 1088 patients (550 pregnant; 538 nonpregnant) with clinically and biochemically confirmed acute viral hepatitis (AVH) or acute liver failure (ALF) and were subjected to a complete panel of hepatitis serology.
In the pregnant cohort, HEV was the cause of infection in 80.36% (442/550) of cases, whereas non-HEV accounted for 19.63 (108/550) of cases. In the ALF pregnant group, the prevalence of HEV was observed in 73.38% (102/139) of cases, whereas other viruses accounted for 26.61% (37/139) of illness. Ninety-eight of 129 (75.96%) cases of HEV-infected pregnant women died, whereas non-HEV infection was responsible for only 31 of 129 (24.04%) cases' death in comparison. Serum viral load in the ALF group was also significantly higher than that in the AVH group in the pregnant (24578.6 ± 12410.3 vs. 6821.9 ± 1832.7, respectively) cohort and nonpregnant cohort (583.6 ± 187.34 vs. 298.68 ± 65.77, respectively).
HEV infection has a higher incidence, more severe course, and greater mortality in the pregnant cohort than in the nonpregnant cohort.
本研究旨在检验戊型肝炎病毒（HEV）相关肝病在妊娠期病情及严重程度是否更严重这一假设。
这项前瞻性研究纳入了1088例临床及生化确诊为急性病毒性肝炎（AVH）或急性肝衰竭（ALF）的患者（550例孕妇；538例非孕妇），并对其进行了全套肝炎血清学检查。
在孕妇队列中，80.36%（442/550）的病例感染原因是HEV，而19.63%（108/550）的病例感染原因是非HEV。在急性肝衰竭孕妇组中，73.38%（102/139）的病例检测出HEV感染，而其他病毒导致的病例占26.61%（37/139）。129例HEV感染孕妇中有98例（75.96%）死亡，相比之下，非HEV感染导致129例中的31例（24.04%）死亡。孕妇队列和非孕妇队列中，急性肝衰竭组的血清病毒载量也显著高于急性病毒性肝炎组（孕妇队列中分别为24578.6±12410.3和6821.9±1832.7，非孕妇队列中分别为583.6±187.34和298.68±65.77）。
与非孕妇队列相比，孕妇队列中HEV感染的发生率更高、病程更严重且死亡率更高。
