Seroprevalence of subclinical HEV infection in asymptomatic, apparently healthy, pregnant women in Dakahlya Governorate, Egypt

Background/Aim: Hepatitis E virus (HEV) is a major public health problem in the developing countries. HEV infection in pregnant women is more common and fatal in the third trimester. The present study was designed to determine the seroprevalence of subclinical HEV infection in asymptomatic pregnant women. Materials and Methods: A total of 116 asymptomatic pregnant women divided into group 1, including 56 pregnant women with hepatitis C virus (HCV)-positive serology and group 2, including 60 pregnant women with negative HCV serology were included in this study. The prevalence of anti-HEV antibodies and anti-HCV was determined by an enzyme-linked immunosorbent assay (ELISA) kit. Results : The o verall prevalence of anti-HEV IgG was highly significant among pregnant women with chronic HCV infection [40/56 (71.42%)] than in pregnant women free from chronic HCV infection [28/60 (46.7%)] (P = 0.006). Chronic HCV infection in pregnant women appeared to be a risk factor associated with HEV IgG seropositivity (OR = 2.86, CI = 1.24-6.6 ). The seropositivity of anti-HEV IgG was significantly high in rural areas than in urban areas (62.5% versus 37.5%) in group 1 and (78.58% versus 21.42%) in group 2 (P = 0.15) (OR = 2.2, CI = 0.65-7.7). A significant decrease in albumin (P = 0.047) and increase in bilirubin (P = 0.025), ALT (P = 0.032) and AST (P = 0.044) in pregnant women with positive HCV and IgG anti-HEV than in the second group with negative HCV serology was noted. Conclusions : The seroprevalence of anti-HEV IgG in pregnant women is high in Egypt, especially in the rural areas. With chronic HCV coinfection, marked increase in anti-HEV IgG seropositivity and significant worsening of the biochemical liver indices were noted. Increased public awareness about sound hygienic measures for a lower prevalence of HEV is strongly advised. The need for HEV vaccination for those at risk, especially pregnant ladies, should be considered.