Hepatitis E virus infection in pregnancy: A narrative review

Area of Science:

• Hepatology
• Infectious Diseases
• Maternal-Fetal Medicine

Background:

• Hepatitis E virus (HEV) is a significant cause of acute viral hepatitis globally.
• Pregnancy amplifies HEV severity, especially with genotypes 1 and 2, in tropical and low-resource settings.
• HEV in pregnancy is linked to high maternal mortality, liver failure, and poor fetal outcomes in the WHO Southeast Asia region.

Purpose of the Study:

• To review current evidence on HEV epidemiology, pathogenesis, clinical features, and outcomes in pregnant women in tropical areas.
• To identify challenges in managing HEV during pregnancy and explore prevention strategies.
• To provide practical recommendations for clinicians and health systems in endemic regions.

Main Methods:

• This is a narrative review synthesizing contemporary scientific evidence.
• The review focuses on HEV infection in pregnant women within tropical practice settings.
• Key areas covered include epidemiology, pathogenesis, clinical presentation, outcomes, management, and prevention.

Main Results:

• HEV infection during pregnancy in tropical settings is associated with high maternal mortality and severe fetal complications.
• Significant gaps exist in diagnostic capabilities, access to critical care, and vaccine availability for HEV.
• Current management strategies face challenges in low-resource environments.

Conclusions:

• Urgent improvements in surveillance, outbreak preparedness, and antenatal counseling are needed.
• Integrating pregnant women into vaccine policy discussions is essential.
• Addressing critical gaps in healthcare infrastructure and access is vital to reduce HEV-related maternal and fetal deaths.