title: Incidence and seroprevalence of hepatitis E virus infection in pregnant women infected with hepatitis B virus and antibody placental transfer in infants.
abstract: Hepatitis E has poor outcomes in pregnant women. Superinfection of hepatitis E virus (HEV) in patients infected with hepatitis B virus (HBV) may worsen liver disease.
  
  
  
  To estimate the incidence and seroprevalence of HEV infection among HBV-infected pregnant women, to investigate the transplacental transfer of maternal anti-HEV IgG, and to compare the maternal and neonatal outcomes in anti-HEV positive and negative pregnant women.
  
  
  
  Totally 391 HBV-infected pregnant women were recruited from April 2012 to October 2014. Paired mothers and infants were followed up at an average 9.8 months postpartum. Anti-HEV IgG and IgM were tested by ELISA.
  
  
  
  Of the pregnant women, none was anti-HEV IgM positive and 42 (10.7%) were IgG positive. At the follow-up, 3 seronegative women converted to anti-HEV IgG positive, with an estimated incidence of 17 per 1000 person-years. No significant differences of gestational age, preterm birth rate, Apgar score and birthweight were observed between newborns of anti-HEV IgG positive and negative mothers. Of the 42 neonates born to anti-HEV IgG positive mothers, 38 (90.5%) had anti-HEV IgG in their cord blood. The neonatal and maternal anti-HEV IgG levels were positively correlated (r=0.827, p<0.05). All infants were negative for both anti-HEV IgM and IgG at the follow-up.
  
  
  
  HBV-infected pregnant women rarely have novel HEV infection during late pregnancy in Jiangsu, China. Maternal anti-HEV IgG efficiently transfers into the fetuses, and disappears in infants before 10 months old.
authors.affiliation: Department of Experimental Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China. Electronic address: hhy_fish@163.com.
authors.forename: Hongyu
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang 212000, China. Electronic address: 77304270@qq.com.
authors.forename: Chenyu
authors.initials: C
authors.lastname: Xu
authors.affiliation: Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. Electronic address: zhouxuan_diana@163.com.
authors.forename: Xuan
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou 225400, China. Electronic address: 89110541@qq.com.
authors.forename: Lanhua
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. Electronic address: nj_daiyimin@126.com.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou 225400, China. Electronic address: xupeizhen2011@163.com.
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Obstetrics and Gynecology, Taixing People's Hospital, Taizhou 225400, China. Electronic address: summeryang@126.com.
authors.forename: Jishi
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang 212000, China. Electronic address: tingmei301@sina.com.
authors.forename: Tingmei
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. Electronic address: dtylhu@126.com.
authors.forename: Yali
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Experimental Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China; Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing 210008, China; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China. Electronic address: zgr03summer@126.com.
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Zhou
mesh_terms: D000328:Adult; D002681:China; D060085:Coinfection / Q000453:epidemiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006508:Hepatitis Antibodies / Q000097:blood*; D006509:Hepatitis B / Q000150:complications*; D016751:Hepatitis E / Q000453:epidemiology*; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D016036:Seroepidemiologic Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D006508:Hepatitis Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: Hepatitis B virus (HBV); Hepatitis E virus (HEV); Pregnant women; Transplacental transfer of anti-HEV