Hepatitis E seroprevalence in pregnancy

The occurrence of hepatitis E virus (HEV) infection in pregnant women is a significant concern for maternal and neonatal health. Detection of HEV can be done through anti-HEV antibodies (immunoglobulin G [IgG] and immunoglobulin M [IgM]) or RNA-based tests. Robust estimates of exposure of hepatitis E among pregnant women in northern India are limited. So, this study was done to evaluate the seroprevalence of hepatitis E in pregnant females.

The prospective cohort study was conducted at the department of obstetrics and gynecology for one year. The study was approved by the Institutional Ethical Committee (ECR/262/Inst/UP/2013RR-19 Ref code XV-PGTSC-IIA/P24). A 5-mL blood sample was collected from each participant's median cubital vein, centrifuged and serum/plasma separated early to prevent hemolysis of red blood cells and stored at - 20 °C for further analysis. The study used the Wantai HEV IgG ELISA diagnostic kit manufactured in Beijing, a commercially available enzyme-linked immunosorbent assay for qualitative detection of IgG antibodies to hepatitis E virus in human serum or plasma. Results were calculated by relating each specimen absorbance value to the cut-off value (C.O). All specimens fulfilled quality control criteria and the index was defined as A/C.O.

Of 602 pregnant patients tested, 287 patients (47.7%) were IgG HEV positive and 326 patients (52.3%) were IgG HEV negative. Seropositivity increases with an increase in age. Total 51.3% of rural area females were seropositive than 45.3% in urban population. Low body mass index (BMI) was associated with high seropositivity.

Seroprevalence of hepatitis E in the north Indian population in the present study was quite high. The result of the present study can be used in formulating the guidelines for hepatitis E vaccination in pregnant females.