title: Mother-to-child transmission of hepatitis E virus infection.
abstract: OBJECTIVE
  Water borne or enterically transmitted non-A-non-B hepatitis is a major public health problem in India. Many of these cases carry fatal outcome. The hepatitis E virus (HEV) has been considered to be the most important causative agent of this entity. The severity and fatality rates of HEV infection are reported to be rather more in pregnant women. However, there is meager information from India, on mother to child transmission of this agent.
  
  
  METHODS
  During 1997-98, we studied 60 pregnant women suspected to have acute viral hepatitis to understand the frequency of various viral etiologies, disease course and outcome of the pregnancy. Six cord blood samples were tested for IgG, and IgM antibodies against hepatropic viral agents and also for hepatitis E virus RNA by RT-nested PCR using ORF-1 as target.
  
  
  RESULTS
  Of the 60 pregnant patients hospitalised at All India Institute of Medical Sciences, New Delhi for acute hepatitis, 22 (37%) were positive for IgM anti-HEV antibodies and 10% were infected with hepatitis B virus. Co-infection of HEV with Hepatitis B and C was seen in 1 and 2 patents, respectively. Most (72%) of the HEV infected patients were in third trimester of pregnancy (P<0.05). Of the 6 cord blood samples tested 3 (50%) were positive for HEV RNA. Though, all mothers were RNA positive, half of the babies did not get infected in utero with HEV. Fourteen of the 22 (63.6%) HEV infected mothers developed fulminant hepatic failure and all died.
  
  
  CONCLUSIONS
  The mortality rate in HEV [corrected] infected mothers was 100%. Mother to child transmission of hepatitis E virus infection was established in 50%.
authors.affiliation: Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India. ssingh56@hotmail.com
authors.forename: Sarman
authors.initials: S
authors.lastname: Singh
authors.forename: Alok
authors.initials: A
authors.lastname: Mohanty
authors.forename: Y K
authors.initials: YK
authors.lastname: Joshi
authors.forename: Deepika
authors.initials: D
authors.lastname: Deka
authors.forename: Sujit
authors.initials: S
authors.lastname: Mohanty
authors.forename: S K
authors.initials: SK
authors.lastname: Panda
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D016751:Hepatitis E / Q000276:immunology / Q000635:transmission*; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007194:India; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M