Laboratory of Infectious Diseases, Institute for Developing Science and Health Initiatives, Mohakhali, Dhaka 1212, Bangladesh; Department of Microbiology, University of Dhaka, Dhaka 1000, Bangladesh; Department of Immunology, Bangladesh University of Health Sciences, Mirpur, Dhaka 1216, Bangladesh.
Laboratory of Infectious Diseases, Institute for Developing Science and Health Initiatives, Mohakhali, Dhaka 1212, Bangladesh; Laboratory of Genetics and Genomics, Institute for Developing Science and Health Initiatives, Mohakhali, Dhaka 1212, Bangladesh.
Int J Infect Dis. 2021 Mar;104:482-490. doi: 10.1016/j.ijid.2020.12.081. Epub 2021 Jan 15.
To determine IgG immune responses and hepatitis E virus (HEV) viral load, and to explore the associations with pregnancy.
A total of 121 HEV-infected women (57 pregnant, 64 non-pregnant) were analysed. Quantitative reverse transcription PCR (RT-qPCR) was done for 78 HEV IgM-positive patients to determine viral load, and Sanger sequencing was performed for 62 HEV-RNA-positive patients to confirm genotyping. ELISA was conducted to determine HEV antibody and avidity indices.
The HEV genotype was identified as variant 1. Significant negative correlations were observed between log HEV copy number and log hepatitis E virus IgG antibody index in the late acute phase of jaundice for both pregnant women (r = -0.7971, p = 0.0002) and non-pregnant women (r = -0.9117, p = 0.0002). Pregnant women had significantly higher serum log viral copy numbers and lower IgG antibody indices than non-pregnant women in the late acute phase of HEV-induced jaundice (p = 0.0196 and p = 0.0303, respectively). Moreover, pregnant women with acute HEV hepatitis had higher cross-reactive IgG antibodies compared to the non-pregnant women (p = 0.0017). Five patients with HEV hepatitis died, of whom four were pregnant.
Pregnancy might be associated with higher viral loads and a lower IgG response in the HEV-induced late acute phase of jaundice.
确定 IgG 免疫反应和戊型肝炎病毒（HEV）病毒载量，并探讨其与妊娠的关系。
对 121 例 HEV 感染的女性（57 例妊娠，64 例非妊娠）进行分析。对 78 例 HEV IgM 阳性患者进行定量逆转录 PCR（RT-qPCR）以确定病毒载量，并对 62 例 HEV-RNA 阳性患者进行 Sanger 测序以确认基因分型。采用 ELISA 法检测 HEV 抗体和亲和指数。
确定 HEV 基因型为 1 型。在黄疸的急性后期，孕妇（r = -0.7971，p = 0.0002）和非孕妇（r = -0.9117，p = 0.0002）的 HEV 拷贝数与 HEV IgG 抗体指数之间均存在显著负相关。在黄疸的急性后期，孕妇的血清 log 病毒拷贝数明显高于非孕妇，而 IgG 抗体指数明显低于非孕妇（p = 0.0196 和 p = 0.0303）。此外，急性 HEV 肝炎孕妇的交叉反应性 IgG 抗体明显高于非孕妇（p = 0.0017）。5 例 HEV 肝炎患者死亡，其中 4 例为孕妇。
妊娠可能与黄疸急性后期 HEV 诱导的更高病毒载量和更低的 IgG 反应有关。
