Hepatitis E Virus Infection in Pregnant Women

Hepatitis E virus (HEV) is a major global public health concern, particularly in resource-limited regions. Approximately 12.5% of individuals worldwide have been exposed to HEV, and 15-110 million individuals have current or recent HEV infection. HEV poses an especially serious threat to pregnant women, in whom infection can progress to severe disease and is associated with a high case fatality rate, particularly during the third trimester. Moreover, maternal HEV infection can lead to various adverse outcomes in fetuses and/or neonates, as documented in both developing and developed countries. No HEV-specific antiviral therapy is approved for use during pregnancy, and pregnancy-specific evidence and recommendations for HEV vaccination remain limited. This narrative review summarizes the diagnosis, prevalence, clinical manifestations, mechanisms underlying severe disease, treatment, and prevention of HEV infection in this high-risk population. It aims to improve clinicians' awareness of the potential impact of HEV infection on pregnant women and their fetuses/neonates, to promote public health literacy, and to accelerate future disease-control efforts.