‘Pregnant women more vulnerable to Hepatitis E-induced liver failure’

Thursday, July 26, 2012

New Delhi: In one of the widest single-centre studies conducted by the All India Institute of Medical Sciences (AIIMS) here, it was found that water-borne Hepatitis E was the basic cause of acute liver failure in nearly 60 per cent of pregnant women.

Dr S K Acharya

Hepatitis E, a preventable disease, is transmitted mainly through contaminated drinking water and can lead to death by triggering acute liver failure. Post failure, the liver is not able to remove toxic substances in the blood.

The two-decade study closely examined over 1,000 consecutive patients admitted at AIIMS from January 1986 to December 2006. It compared the progression of Hepatitis E in pregnant women, non-pregnant women and men in the age group 15-45 years.

“We found that Hepatitis E was the causative agent of acute liver failure in among 60 per cent of pregnant women and girls. However, the virus caused acute liver failure in only 30 per cent non-pregnant females,” Dr S K Acharya, head of the department of gastroenterology at AIIMS, told IANS.

“Among men, only 23 per cent were affected by liver failure caused by Hepatitis E,” said Dr Acharya, who is also the co-author of the study.

Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. In the study, 249 pregnant women were compared with 341 non-pregnant females and 425 males.

“Pregnant women may be more vulnerable to infection by Hepatitis E virus. The mortality rate among hepatic pregnant women was found to be over 50 per cent,” the study noted.

The study puts pregnant women at an increased vulnerability to Hepatitis E, leaving them with more cautions to follow on hygiene, safe drinking water and sanitation.

“There is a general liver insufficiency or weakness during pregnancy. So, Hepatitis E virus has a higher attack rate and progression in pregnant women,” Dr Acharya explained.

There are five main Hepatitis viruses – types A, B, C, D and E. Other than viral infection, Hepatitis is also caused by alcohol, drugs, chemicals, fatty liver and autoimmune disease.

According to the World Health Organisation (WHO) estimates, nearly 5 million people will loose life due to viral Hepatitis over the next decade in Southeast Asia.

The UN health agency says that the Indian subcontinent, China and other countries in Southeast Asia bear the highest burden of acute liver failure.

The study bears out the WHO statistics, adding: “Although pregnancy does not grant increased susceptibility to Hepatitis A, B, and C viruses, pregnant women may be more vulnerable to infection by Hepatitis E virus.”

However, rather than waiting for a vaccine, experts say the preventive measures come handy and help in preventing the disease to a great extent.

“The vaccine for Hepatitis E is still in the pipeline, but the issue is that all causes of Hepatitis E are very much preventable,” said Dr A S Puri, a professor at the department of gastroenterology at G B Pant hospital.

“The virus is transmitted through faecal-oral route, contaminated drinking water which all reflect poor sanitation,” Dr Puri told IANS.

According to WHO, China has produced and licensed the first vaccine to prevent Hepatitis E. The vaccine is yet to be available globally. [Source: IANS]

Categories: Hepatology, RESEARCH

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