scholarly journals Fetomaternal outcome in pregnancy with hepatitis E infection

2020 ◽  
Vol 10 (1) ◽  
pp. 145
Author(s):  
Preeti F. Lewis ◽  
Sampada Prasad ◽  
Nitin B. Bavdekar
Keyword(s):  
Viral Hepatitis ◽  
Acute Viral Hepatitis ◽  
Post Partum ◽  
Tertiary Care ◽  
Case Fatality ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
Health Concern ◽  
Still Births ◽  
Post Partum Period

Background: HEV infection, a major public health concern, is known to cause large-scale epidemic and sporadic cases of acute viral hepatitis in developing countries. The infection occurs primarily in young adults and is generally mild and self-limiting; however, the case fatality rate is reportedly higher among pregnant women.Methods: Our study, a retrospective observational study, was conducted in a tertiary care center for over a period of 3 years (January 2017 to January 2020) to find out the fetal and maternal outcome in pregnant women with HEV infection.Results: A total of 38 antenatal cases with anti-HEV IgM-positive were included, and the maternal-fetal outcome was analyzed. The maternal mortality was 52.63 % especially during 3rd trimester and post-partum period, including 5 antenatal death. The most common maternal complication was acute fulminant hepatitis (39.5 %), DIC (36.8 %) and hepatic encephalopathy (31.6%). Prematurity (33.3% of total live births) and Still births (32.3 %) including 4 freshes still births were the commonest fetal complications noted.Conclusions: Our study shows that pregnant woman with acute viral hepatitis due to hepatitis E virus infection had a high mortality rate especially during 3rd trimester and post-partum period with poor obstetric and fetal outcome.

scholarly journals Seroprevalence of Enterically Transmitted Hepatitis Viruses in Patients Attending a Tertiary Care Hospital in Maharashtra, India

2021 ◽  
Vol 10 (30) ◽  
pp. 2310-2313
Author(s):  
Suvarna Vaibhav Sande
Keyword(s):  
Acute Hepatitis ◽  
Viral Hepatitis ◽  
Predictive Value ◽  
Hepatitis A ◽  
Acute Viral Hepatitis ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Care Hospital ◽  
Serum Samples ◽  
Hepatitis Viruses

BACKGROUND Hepatitis A & E viruses are enterically transmitted viruses responsible for acute viral hepatitis in developing countries. Hepatitis A virus (HAV) has worldwide distribution while hepatitis E virus (HEV) is restricted to tropical countries. HAV affects infants and young children while HEV affects older children and young adults. This study was conducted to determine the seroprevalence of HAV and HEV and their co-infection in patients presenting with acute viral hepatitis (AVH). METHODS 200 sera of patients suffering from suspected acute viral hepatitis (AVH) attending tertiary care rural hospital JNMC Sawangi, Wardha were included in the study. Serum samples were tested for IgM anti HAV and IgM anti - HEV for the detection of acute hepatitis A and acute hepatitis E using commercially available ELISA kit & Immunochromatography test (ICT) for comparison of ELISA and ICT. RESULTS The overall seroprevalence of HAV and HEV infection was found to be 19 %. The seroprevalence of HAV infection was found to be 13 %, HEV infection 5 % and HAV - HEV co - infection 1 %. HAV infection in males and females was found to be 16.07 % and 9.09 % respectively & HEV infection was found to be 5.35 % and 4.54 % respectively. In case of detection of HAV IgM, two serum samples were negative by ICT but positive by ELISA & for HEV IgM, one serum sample was negative by ICT but positive by ELISA. The sensitivity, specificity, positive predictive value and negative predictive value of HAV IgM was found to be 96 %, 98.8 %, 92.30 % & 99.43 % and for HEV IgM was found to be 90 %, 99.47 %, 90 % & 99.47 % respectively. CONCLUSIONS It is evident from this study that infection with enteric hepatitis viruses is not infrequent. Findings from this study emphasize the need to establish regular seroepidemiological surveys to keep track of epidemiology of these viruses. Results from rapid tests are comparable to ELISA with additional advantage of ease of interpretation and neither time consuming nor requiring special instruments. KEY WORDS Hepatitis A, Hepatitis E, Seroprevalence

scholarly journals A study of fetomaternal outcome of hepatic disorders in pregnancy

2019 ◽  
Vol 8 (3) ◽  
pp. 1182
Author(s):  
Mahima Jain ◽  
Himani Thaker
Keyword(s):  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Rural Areas ◽  
Acute Viral Hepatitis ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Fetal Outcome ◽  
The Body ◽  
Mortality And Morbidity ◽  
In Pregnancy

Background: Liver is a vital organ to maintain physiology of the body and supports every organ of the body. Its proper functioning during pregnancy is essential for a good maternal and fetal outcome. The study analyses the causes and fetomaternal outcome in pregnancies with jaundice and suggests measures to reduce morbidity and mortality.Methods: This is a one-year prospective study in a tertiary care institute during which 7165 deliveries are conducted. Total 55 cases of Jaundice with pregnancy are identified and studied for clinical, biochemical profile, etiology and maternal and fetal outcome. 8 maternal deaths are reported amongst this study group.Results: In this study 55 cases of hepatic disorders in pregnancy are studied. The age group reported is 21-29 years. Majority 72% cases belong to rural areas and 85% in lower socioeconomic class. 96.3% patients were in the third trimester of pregnancy. Most common etiology of hepatic disorders in pregnancy is acute viral hepatitis followed by intrahepatic cholestasis of  pregnancy and preeclampsia and HELLP syndrome. In acute viral hepatitis 81% patients were hepatitis E positive. Most common complication are DIC followed by hemorrhagic shock and subsequently AKI and septicemia. 77.7% babies were born alive and 30.9% NICU admission due to severe birth asphyxia and prematurity. Of these 16.6% died in neonatal period. Maternal mortality in 14.5% patients due to viral hepatits, HELLP and septicemia.Conclusions: Jaundice in pregnancy is a rare medical disorder and deadly combination affecting maternal and fetal outcome. Earl detection and timely intervention with multidisciplinary approach including obstetrician, neonatologist, intensivist and skilled nursing care can help to reduce maternal mortality and morbidity.

Hepatitis-E: Clinical profile and outcome assessment from India

2021 ◽  
Vol 11 (2) ◽  
pp. 139-141
Author(s):  
Venu H Aradya ◽  
Keyword(s):  
Liver Disease ◽  
Liver Failure ◽  
Viral Hepatitis ◽  
Acute Viral Hepatitis ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Chronic Liver ◽  
Enzyme Linked Immunosorbent Assay ◽  
Care Hospital ◽  
Study Results

Background: Hepatitis E is the most common cause of acute viral hepatitis in the adult population in India. Hepatitis-E has self-limiting clinical course, but can be life threatening in certain high risk groups like pregnancy and alcoholic liver disease. . The present study evaluated the predictors of mortality in patients with acute Hepatitis-E cases at a tertiary care center from India. Methods: This cross sectional study including cases of viral Hepatitis E was done at tertiary care hospital at Mysore during January 2016 to November 2016. A total of seventy nine patients diagnosed with HEV infection using IgM anti-HEV enzyme-linked immunosorbent assay (ELISA) kits were included in the study. Results: Out of seventy nine, forty two (53.2%) patients were males and thirty seven (46.8%) were females. The mean age of our study group was 44.3±13.47 years. Out of seventy nine Hepatitis E patients, six had coinfection, two with Hepatitis A (2.5%) and four (5.1%) were HBsAg positive. A total of seventy three (92.4%) patients survived while six (7.6%) patients expired during the course of the illness. Among six fatal cases, four (66.7%) died of acute on chronic liver failure and two (33.6%) died of acute liver failure (ALF). Conclusion: Pre-existing chronic liver disease was found to be significantly associated with mortality in patients suffering from viral Hepatitis E. Increased bilirubin, Low serum albumin, alcohol use, were also associated with increased mortality due to acute viral hepatitis E. Pregnancy was not a determinant of mortality in Hepatitis-E patients in this study.

scholarly journals Associated comorbidities with obesity in pregnancy and its feto-maternal outcome

2019 ◽  
Vol 8 (7) ◽  
pp. 2785
Author(s):  
Rupam Sanjay Jain ◽  
Sneha D. Shirodkar
Keyword(s):  
Negative Impact ◽  
Post Partum ◽  
Tertiary Care ◽  
Preterm Births ◽  
Fetal Outcome ◽  
Obese Women ◽  
Global Epidemic ◽  
Still Births ◽  
Observational Cohort ◽  
Obesity In Pregnancy

Background: Obesity is an evolving risk factor in the modern day - a rising global epidemic reported to cause many problems in the pregnant woman - causing ill effects to both the mother and the fetus. Managing the comorbidities associated with obesity is a challenge in obstetric care.Methods: This prospective observational cohort study was conducted at a tertiary care institute over a period of 2 years. 50 antenatal patients fulfilling the inclusion criteria were studied after taking informed consent. The various maternal, fetal and neonatal outcomes were noted to examine the magnitude and significance of the effect of BMI.Results: Obese women have a higher prevalence of infertility and are considered a high-risk state because pregnancy is associated with a higher risk of pre-eclampsia, gestational diabetes mellitus, preterm labour, increased operative and caesarean deliveries, post-partum haemorrhage, post-partum infectious morbidities and a higher incidence of anesthetic and post-operative complications in these deliveries. Neonatal complications include congenital anomalies, fetal macrosomia leading to birth injuries, preterm births and still births. Technical difficulties are faced by the obstetricians while operating and by the anesthesiologists while induction.Conclusions: Considering the adverse effects of obesity on pregnancy outcomes, pre-pregnancy counseling should be done for all overweight and obese females planning conception signifying the negative impact of obesity on maternal and fetal outcome.

scholarly journals Co-infection of Hepatitis A and Hepatitis E Viruses among the Acute Viral Hepatitis Cases in Tertiary Care Hospital –A Four Years Retrospective Study

2020 ◽  
Vol 14 (3) ◽  
pp. 2047-2051
Author(s):  
Ravindra V. Shinde ◽  
Anjali R. Shinde ◽  
Anjali D. Patil ◽  
S.K. Pawar ◽  
S.T. Mohite ◽  
...  
Keyword(s):  
Viral Hepatitis ◽  
Hepatitis A ◽  
Acute Viral Hepatitis ◽  
Care Center ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Care Hospital ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Health Care Center

Acute viral hepatitis(AVH) is caused by Hepatitis A (HAV) and Hepatitis E(HEV). It is major health burden in India. Both the viruses HAV and HEV are primarily transmitted via the faeco-oral course. Study was conducted to determine the seroprevalence of HAV, HEV and rate of co-infection in AVH patients attending rural tertiary care centre. A retrospective laboratory record based study was carried out in rural tertiary health care center located in Western Maharashtra. Laboratory and Medical records of suspected acute viral infection patients were analyzed during study. Study period was June 2014 to July 2018. Commercially available ELISA kits of IgM anti-HAV and IgM anti-HEV were used to analyze serum samples of suspected study participants. Tests were carried out as per the manufacturer’s instructions. A total of 778 acute viral hepatitis cases were included in the study from July 2014 to July 2018 among which 85/778 (10.9 %) detected positive for HAV and 121/778 (15.6%) detected positive for HEV. Co-infection was identified in 6/778(0.8 %). Jaundice, fever fatigue and hepatomegaly were common clinical presentation in HAV, HEV and confection with both viruses in acute viral hepatitis patients. Study indicated low exposure to HAV in childhood bellow 16 years. Co-infection rate was detected high in 16-25 years age group. Vaccination policy against HAV in adolescent age group needed as there is change epidemiological shift of HAV which has been observed in the current study. These data will helps for planning future vaccination strategies, better implementation sanitation program, and safe water supply in this geographic area.

scholarly journals Identification of Hepatitis E Virus Genotypes 3 and 7 in Israel: A Public Health Concern?

Viruses ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2326
Author(s):  
Rachel Shirazi ◽  
Paolo Pozzi ◽  
Yael Gozlan ◽  
Marina Wax ◽  
Yaniv Lustig ◽  
...  
Keyword(s):  
Viral Hepatitis ◽  
United Arab Emirates ◽  
Hepatitis E ◽  
Developed Countries ◽  
Chronic Viral Hepatitis ◽  
Amino Acid Sequences ◽  
Health Concern ◽  
Dromedary Camel ◽  
Genotype 3 ◽  
Isolation And Characterization

Background: Hepatitis E (HEV) is an emerging cause of viral hepatitis worldwide. Swine carrying hepatitis E genotype 3 (HEV-3) are responsible for the majority of chronic viral hepatitis cases in developed countries. Recently, genotype 7 (HEV-7), isolated from a dromedary camel in the United Arab Emirates, was also associated with chronic viral hepatitis in a transplant recipient. In Israel, chronic HEV infection has not yet been reported, although HEV seroprevalence in humans is ~10%. Camels and swine are >65% seropositive. Here we report on the isolation and characterization of HEV from local camels and swine. Methods: Sera from camels (n = 142), feces from swine (n = 18) and blood from patients suspected of hepatitis E (n = 101) were collected during 2017–2020 and used to detect and characterize HEV sequences. Results: HEV-3 isolated from local swine and the camel-derived HEV-7 sequence were highly similar to HEV-3f and HEV-7 sequences (88.2% and 86.4%, respectively) related to viral hepatitis. The deduced amino acid sequences of both isolates were also highly conserved (>98%). Two patients were HEV-RNA positive; acute HEV-1 infection could be confirmed in one of them. Discussion: The absence of any reported HEV-3 and HEV-7 infection in humans remains puzzling, especially considering the reported seroprevalence rates, the similarity between HEV sequences related to chronic hepatitis and the HEV genotypes identified in swine and camels in Israel.

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