Hepatitis E and pregnancy: understanding the pathogenesis.

摘要: Hepatitis E virus (HEV) is a single-stranded RNA that causes large-scale epidemics of acute viral hepatitis, particularly in developing countries. In men and non-pregnant women, the disease usually self-limited has case-fatality rate less than <0.1%. However, pregnant from certain geographical areas India, HEV infection more severe, often leading to fulminant hepatic failure death significant proportion patients. contrast, reports Egypt, Europe USA have shown course severity hepatitis during pregnancy not different women. The reasons for this difference are clear. high mortality been thought be secondary associated hormonal (oestrogen progesterone) changes consequent immunological changes. These include downregulation p65 component nuclear factor (NF-kappaB) with predominant T-helper type 2 (Th2) bias T-cell response along host susceptibility factors, mediated by human leucocyte antigen expression. Thus far, researchers were unable explain morbidity pregnancy, why it other viruses such as A similar epidemiological features reason behind women regions. recent developments understanding immune encouraged us review possible mechanisms these differences. Further research immunology required conquer near future.