Prevalence of hepatitis E virus infection among pregnant women in Zhenjiang, China

Abstract

Background

Most hepatitis E virus (HEV) infections are mild or subclinical, however, the infections are characteristically associated with a high incidence of symptomatic presentation among pregnant women.

Objectives

The aim of this study was to assess the HEV prevalence among pregnant women in Zhenjiang, China.

Materials and methods

225 and 208 of serum samples collected from pregnant and healthy nonpregnant women, respectively, were used to detect anti-HEV IgG and IgM levels. IgM positive samples were further tested for HEV RNA by using RT-nested PCR (nPCR) method. Positive PCR products were sequenced and subjected to phylogenetic analysis.

Results

21.8% (49/225) of samples were anti-HEV IgG positive in pregnant women, whereas 7.7% (16/208) of samples were anti-HEV IgG positive in control subjects (P < 0.001). With respect to anti-HEV IgM testing, 3.6% (8/225) and 0.0% (0/208) were positive in pregnant women and control subjects, respectively (P = 0.006 < 0.01). 4 out of 8 IgM positive samples were positive for HEV RNA. Phylogenetic analysis indicated that four HEV strains had distinct nucleotide sequences and clustered into two different sub-genotypes in genotype 4.

Conclusions

In the current study, the prevalence of HEV infection with respect to IgG and IgM levels among pregnant women was significantly higher than that in the healthy nonpregnant group. Additionally, all four HEV strains belonged to genotype 4 implying that genotype 4 is the predominant genotype in the area.