Huy Pham Xuan, Chung Dang Thanh, Linh Dang Thuy, Hang Ngo Thu, Rachakonda Sivaramakrishna, Pallerla Srinivas Reddy, Linh Le Thi Kieu, Tong Hoang Van, Dung Le Minh, Mao Can Van, Wedemeyer Heiner, Bock C-Thomas, Kremsner Peter G, Song Le Huu, Sy Bui Tien, Toan Nguyen Linh, Velavan Thirumalaisamy P
Department of Pathophysiology, Vietnam Military Medical University, Hanoi 100000, Vietnam.
Institute of Tropical Medicine, Universitätsklinikum Tübingen, 72074 Tübingen, Germany.
Pathogens. 2021 Oct 17;10(10):1340. doi: 10.3390/pathogens10101340.
Infections with HEV in low- and middle-income countries (LMICs) are associated with increased rates of preterm birth, miscarriage, and stillbirth. The aim of the present study was to investigate HEV infections in pregnant women and the possibility of mother-to-child transmission, and associated outcomes. A total of 183 pregnant women in their third trimester were recruited and followed until delivery. Anti-HEV IgG and IgM were determined via enzyme-linked immunosorbent assay (ELISA), and HEV nucleic acids were detected in stool and cord blood samples. HEV genotypes were identified by Sanger sequencing, and phylogenetic analyses were performed. Mother-to-child transmission and associated adverse outcomes were not observed. Only 2% of patients ( = 4/183) tested positive for anti-HEV IgM, and 8% ( = 14/183) tested positive for anti-HEV IgG antibodies. Cord blood ( = 150) analysis showed that there was no IgM detected, while 4% ( = 6/150) tested positive for anti-HEV IgG, which was consistent with mothers testing positive for anti-HEV IgG. Nucleic acid tests for HEV RNA yielded 2% ( = 4/183) from the serum and stool of pregnant women, and none from cord blood. The HEV isolates belonged to the genotype HEV-3a, with 99% homology with humans and 96% with pigs. No association was found between the risk of HEV infection and pregnancy outcomes or HEV transmission from mother to child. HEV-3 infections of zoonotic origin in pregnancy might have eventually resolved without complications.
低收入和中等收入国家（LMICs）的戊型肝炎病毒（HEV）感染与早产、流产和死产率增加有关。本研究的目的是调查孕妇中的HEV感染情况、母婴传播的可能性以及相关结局。共招募了183名孕晚期妇女并随访至分娩。通过酶联免疫吸附测定（ELISA）测定抗HEV IgG和IgM，并在粪便和脐带血样本中检测HEV核酸。通过桑格测序鉴定HEV基因型，并进行系统发育分析。未观察到母婴传播及相关不良结局。仅2%的患者（=4/183）抗HEV IgM检测呈阳性，8%（=14/183）抗HEV IgG抗体检测呈阳性。脐带血（=150）分析显示未检测到IgM，而4%（=6/150）抗HEV IgG检测呈阳性，这与母亲抗HEV IgG检测呈阳性一致。孕妇血清和粪便中HEV RNA的核酸检测阳性率为2%（=4/183），脐带血中均未检测到。分离出的HEV毒株属于HEV-3a基因型，与人类的同源性为99%，与猪的同源性为96%。未发现HEV感染风险与妊娠结局或母婴HEV传播之间存在关联。妊娠期人畜共患来源的HEV-3感染最终可能已自行缓解且无并发症。
