Hepatitis E Virus

2018 ◽  
Author(s):  
Lisa J. Krain ◽  
Kenrad E. Nelson
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Standard Treatment ◽  
Neonatal Period ◽  
Hepatitis E ◽  
Child Transmission ◽  
The Past ◽  
Maternal Illness ◽  
Increased Risk ◽  
Mother To Child

Hepatitis E virus (HEV) poses serious risks to pregnant women and their developing fetuses, including increased risk of pregnancy loss, stillbirth, preterm delivery, and early infant death. Supportive care is currently the standard treatment for pregnant women with HEV infection, but in some cases, ribavirin treatment or early delivery may be indicated. Infants born with acute HEV infection face increased risk of complications and death. Intensive monitoring and support may be required in the neonatal period, particularly for preterm infants. Infants who survive the early neonatal period are likely to recover fully and clear the virus. Immunoassays and molecular methods for diagnosis of HEV have improved markedly over the past decade. New HEV vaccines may provide an opportunity to prevent both maternal illness and mother-to-child transmission (vertical transmission) (MTCT).

scholarly journals Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study

2021 ◽  
Author(s):  
Rahul Gajbhiye ◽  
Niraj N Mahajan ◽  
Rakesh Waghmare ◽  
Suchitra Vishwambhar Surve ◽  
Prashant Howal ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Post Partum ◽  
Laboratory Data ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Medical Case ◽  
Institutional Ethics ◽  
Increased Risk ◽  
The Impact ◽  
Mother To Child

Introduction: Pregnant women are at increased risk of contracting coronavirus disease 2019 (COVID-19) due to several factors and therefore require special attention. However, consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The aim of PregCovid registry is to document the impact of SARS-CoV-2 infection on pregnant, post-partum women and their new-borns. The aim of the registry is also to determine mother to child transmission of SARS-CoV-2 infection in India. Methods and analysis: PregCovid is a hospital based registry for capturing information of pregnant, post-partum women with COVID-19 and their new-borns in India. Medical case records of pregnant and post-partum women with laboratory confirmed diagnosis of COVID-19 will be captured in real time using an online electronic patient record (EPR) software. The frequency of each symptom will be calculated. The laboratory data will be analyzed for calculating the frequency of laboratory parameters consistently higher in women with COVID-19. The adverse pregnancy and neonatal outcomes will be analyzed and their frequency will be calculated. Response to treatment will be analyzed for frequency calculation (number of women treated with different treatment regimens). The mother to child transmission data will be analyzed from the RT-PCR and/ antibody data of neonatal and maternal samples tested wherever the information is available. The registry data will be crucial for developing strategies for reducing the adverse impact of COVID-19 on pregnant women and their new-born. Ethics and dissemination: The study is approved by the Institutional Ethics Committee of ICMR-National Institute for Research in Reproductive Health (#55/2020), BYL Nair Hospital, Mumbai, India (# 63/2020); and all the 18 participating study sites under Medical Education and Drugs Department of Government of Maharashtra. The Institutional Ethics Committees granted a waiver of consent as the data is collected from the medical case records. Trial registration number: CTRI/2020/05/025423

scholarly journals Hepatitis C Virus Viral Load And Mother-To-Child Transmission: a Systematic Review and Meta - Analysis

2021 ◽  
Author(s):  
Songqing Deng ◽  
Wenfang Zhong ◽  
Wen Chen ◽  
Zilian Wang
Keyword(s):  
Hepatitis C Virus ◽  
Viral Load ◽  
Hepatitis C ◽  
Pregnant Women ◽  
Hcv Rna ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Hiv Coinfection ◽  
Increased Risk ◽  
Mother To Child

Abstract Background: Hepatitis C virus (HCV) infection is increasing among pregnant women own to the opioid epidemic, and mother-to-child transmission (MTCT) was considered to be the leading cause of hepatitis C in the future. Thus, our aim of this study was to assess the association of maternal HCV viral load and human immunodeficiency virus (HIV) coinfection with the risk of MTCT in pregnant women infected by HCV.Methods: We performed a literature searching using MEDLINE, EMBASE, CENTRAL, SCIE, CPCIS, SCOPUS, LILACS and WHO Global Index Medicus from inception to 1 March 2021. Manuscripts were included if they reported the incidence of HCV MTCT. Pooled effect estimates were obtained by using random-effects model and Holm-Bonferroni correction was performed for multiple pooled associations. Results: a total of 26 studies involving 4491 newborns with maternal HCV infected were identified. Pregnant women with HCV viremia had increased risk of MTCT (odds ratio [OR]: 8.14, 95% confidence interval [CI]: 4.62-14.31) compared with those with negative HCV-RNA. Multiple-subgroup analysis showed HCV viremia/HIV+ group experienced the highest risk for HCV MTCT and then HCV viremia mono-infected group; HCV-RNA negative women experienced the lowest risk for HCV MTCT. Among HCV viremia women, elevated risk of MTCT was found in subjects with viral load ≥6 log copies/ml as compared with those with viral load < 6 log copies/ml (OR=4.93, 95% CI: 2.38-10.21). Conclusions: The HCV MTCT incidence is increased in pregnant women with detectable HCV viremia, and is even higher in those with viral load ≥6 log copies/ml. HIV coinfection further increases the risk of HCV MTCT.

Mother-to-child transmission of hepatitis E virus infection

2003 ◽  
Vol 70 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Sarman Singh ◽  
Alok Mohanty ◽  
Y. K. Joshi ◽  
Deepika Deka ◽  
Sujit Mohanty ◽  
...  
Keyword(s):  
Virus Infection ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

scholarly journals Monitoring Prevention Impact of Mother-to-Child Transmission of HIV in Concentrated Epidemics With Program and Survey Data (Preprint)

2017 ◽  
Author(s):  
Thi Thuy Van Nguyen ◽  
Keith Sabin ◽  
Thi Quynh Trang Ho ◽  
Ai Kim Anh Le ◽  
Chika Hayashi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pregnant Women ◽  
Survey Data ◽  
Hiv Transmission ◽  
Late Diagnosis ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Increased Risk ◽  
The Impact ◽  
Mother To Child

BACKGROUND The prevention of mother-to-child transmission (PMTCT) of HIV program was introduced in Vietnam in 2005. Despite the scaling up of PMTCT programs, the rate of mother-to-child HIV transmission in Vietnam was estimated as high as 20% in 2013. OBJECTIVE The objective of this study was to assess the outcomes of PMTCT and identified factors associated with mother-to-child transmission and infant survival using survey and program data in a high HIV burden province in Vietnam. METHODS This community-based retrospective cohort study observed pregnant women diagnosed with HIV infection in Thai Nguyen province from October 2008 to December 2012. Data were collected through interviews using a structured questionnaire and through reviews of log books and medical charts in antenatal care and HIV clinics. Logistic regression and survival analysis were used to analyze data using Stata (StataCorp). RESULTS A total of 172 pregnant women living with HIV were identified between 2008 and 2012. Most of these women had acquired the HIV infection from their husband (77/119, 64.7%). Significant improvement in the PMTCT program was documented, including reduction in late diagnosis of HIV for pregnant women from 62.5% in 2008 to 30% in 2012. Access to antiretrovirals (ARVs) improved, increasing from a rate of 18.2% (2008) to 70.0% (2011) for mothers and from 36.4% (2008) to 93.3% (2012) for infants. For infants, early diagnosis within 2 months of birth reached 66.7% in 2012 compared with 16.7% in 2009. Transmission rate reduced from 27.3% in 2008 to 6.7% in 2012. Late diagnosis was associated with increased risk for HIV transmission (odds ratio [OR] 14.7, 95% CI 1.8-121.4, P=.01), whereas ARV therapy for mother and infant in combination with infant formula feeding were associated with reduced risk for HIV transmission (OR 0.01, 95% CI 0.001-0.1; P<.001). Overall survival rate for HIV-exposed infants at 12 months was 97.7%. CONCLUSIONS A combination of program and survey data measured the impact of prevention of HIV transmission from mother-to-child interventions. Significant improvement in access to the interventions was documented in Thai Nguyen province. However, factors that increased the risk of HIV transmission, such as late diagnosis, remain to be addressed.

Community Based HIV Screening in Pregnant Women and Provision of Prevention of Mother to Child Transmission Care in Rural Zambia

2017 ◽  
Vol 1 (8) ◽  
Author(s):  
Mary Shilalukey Ngoma ◽  
Tepa Nkumbula ◽  
Wilbroad Mutale ◽  
Chabala Chishala ◽  
Reuben Mbewe ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hiv Screening ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Community Based ◽  
Rural Zambia ◽  
Mother To Child

scholarly journals Advances in Hepatitis E Virus Biology and Pathogenesis

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 267
Author(s):  
Shaoli Lin ◽  
Yan-Jin Zhang
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Case Fatality ◽  
Hepatitis E ◽  
Host Cells ◽  
High Rate ◽  
Rapid Progression ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Zoonotic Infections

Hepatitis E virus (HEV) is one of the causative agents for liver inflammation across the world. HEV is a positive-sense single-stranded RNA virus. Human HEV strains mainly belong to four major genotypes in the genus Orthohepevirus A, family Hepeviridae. Among the four genotypes, genotype 1 and 2 are obligate human pathogens, and genotype 3 and 4 cause zoonotic infections. HEV infection with genotype 1 and 2 mainly presents as acute and self-limiting hepatitis in young adults. However, HEV infection of pregnant women with genotype 1 strains can be exacerbated to fulminant hepatitis, resulting in a high rate of case fatality. As pregnant women maintain the balance of maternal-fetal tolerance and effective immunity against invading pathogens, HEV infection with genotype 1 might dysregulate the balance and cause the adverse outcome. Furthermore, HEV infection with genotype 3 can be chronic in immunocompromised patients, with rapid progression, which has been a challenge since it was reported years ago. The virus has a complex interaction with the host cells in downregulating antiviral factors and recruiting elements to generate a conducive environment of replication. The virus-cell interactions at an early stage might determine the consequence of the infection. In this review, advances in HEV virology, viral life cycle, viral interference with the immune response, and the pathogenesis in pregnant women are discussed, and perspectives on these aspects are presented.

scholarly journals Does facility readiness promote high-quality of provider-initiated HIV testing and counseling to pregnant women? A national survey for improving policy of prevention of mother-to-child transmission of HIV in Tanzania

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Deogratius Bintabara ◽  
Athanase Lilungulu ◽  
Shakilu Jumanne ◽  
Mzee M. Nassoro ◽  
Bonaventura C. Mpondo
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
High Quality ◽  
Hiv Testing And Counseling ◽  
Mother To Child ◽  
Facility Readiness ◽  
Testing And Counseling

Abstract Background Provider-initiated HIV testing and counseling (PITC) is a recommended approach to screen for HIV to all pregnant women during antenatal care (ANC) visits, and all with HIV positive results have to be enrolled into prevention of mother-to-child transmission of HIV (PMTCT) program. However, little is known about the relationship between facility readiness and the uptake of PITC to pregnant women attending ANC in Tanzania. Therefore, this study assessed whether the facility readiness promotes the uptake of PITC to the pregnant women attending ANC for the purpose of improving the PMTCT interventions in Tanzania. Methods This study analyzed data for health facilities obtained from the 2014–2015 Tanzania service provision assessment survey. The Primary outcome measure was a composite variable (with score of 0–5) in which its higher scores indicates provision of high-quality of PITC. Also, facilities scored higher in the PMTCT service readiness index were considered to have high readiness to provide PMTCT services. In Poisson regression analyses, a series of models were fitted to assess whether there is an association between provision of high-quality of PITC and facility readiness. In all statistical analysis, a P < 0.05 was considered significant. Results Out of 1853 included first-visit ANC consultations, only about one-third of pregnant women received all five components required for PITC. The mean percentage of PMTCT readiness score was moderate 63.96 [61.32–66.59]%. In adjusted model, we found that facility with high readiness to provide PMTCT services was significantly associated with the provision of high-quality of PITC (model 2: [β = 0.075, P = 0.00]). Conclusion In order to increase high-quality of PITC services, efforts should be made to improve the PMTCT facility readiness by increasing availability of trained staffs, diagnostic tools, and ARTs among health facilities in Tanzania.

scholarly journals Hepatitis E and Pregnancy: An Unholy Alliance Unmasked from Kashmir, India

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1329
Author(s):  
Mohammad Sultan Khuroo
Keyword(s):  
Viral Replication ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Polymerase Activity ◽  
Severe Liver ◽  
Reading Frame ◽  
Multiple Factors ◽  
Severe Liver Disease ◽  
Development And Management

The adverse relationship between viral hepatitis and pregnancy in developing countries had been interpreted as a reflection of retrospectively biased hospital-based data collection by the West. However, the discovery of hepatitis E virus (HEV) as the etiological agent of an epidemic of non-A, non-B hepatitis in Kashmir, and the documenting of the increased incidence and severity of hepatitis E in pregnancy via a house-to-house survey, unmasked this unholy alliance. In the Hepeviridae family, HEV-genotype (gt)1 from genus Orthohepevirus A has a unique open reading frame (ORF)4-encoded protein which enhances viral polymerase activity and viral replication. The epidemics caused by HEV-gt1, but not any other Orthohepevirus A genotype, show an adverse relationship with pregnancy in humans. The pathogenesis of the association is complex and at present not well understood. Possibly multiple factors play a role in causing severe liver disease in the pregnant women including infection and damage to the maternal-fetal interface by HEV-gt1; vertical transmission of HEV to fetus causing severe fetal/neonatal hepatitis; and combined viral and hormone related immune dysfunction of diverse nature in the pregnant women, promoting viral replication. Management is multidisciplinary and needs a close watch for the development and management of acute liver failure. (ALF). Preliminary data suggest beneficial maternal outcomes by early termination of pregnancy in patients with lower grades of encephalopathy.

scholarly journals Achievements and Challenges in the Prevention of Mother-to-Child Transmission of HIV—A Retrospective Cohort Study from a Rural Hospital in Northern Tanzania

2021 ◽  
Vol 18 (5) ◽  
pp. 2751
Author(s):  
Sunniva Marie Nydal ◽  
Yuda Munyaw ◽  
Johan N. Bruun ◽  
Arne Broch Brantsæter
Keyword(s):  
Hiv Infections ◽  
Rural Hospital ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Cd4 Cell Count ◽  
Poor Countries ◽  
Northern Tanzania ◽  
Increased Risk ◽  
Hiv Exposed ◽  
Mother To Child

Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8–49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1–46.1)], and maternal CD4 cell count <200 cells/mm3 [OR = 15.3 (95% CI: 2.1–111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these.

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