HEPATITIS-E VIRUS-INFECTION IN PREGNANCY IN ETHIOPIA

ThirtY-two Pregnant and 34 nonpregnant Ethiopian women between 15 and 45 years of age with sporadic acute viral hepatitis were studied conse cutively. Demographic data including family size, monthly income and n utritional status as well as hepatitis virus markers were compared in the pregnant and nonpregnant groups. Only 3 nonpregnant women had hepa titis A infection. Hepatitis B infection was diagnosed in 4 pregnant a nd 9 nonpregnant women. Nineteen (59%) pregnant women had hepatitis E virus (HEV) infection as compared to 7 (22%) 'in the nonpregnant group (Relative risk = 2.88; 95% Confidence interval = 1.4-5.9). The remain ing 9 pregnant and 15 nonpregnant women had non-A,non-B,non-E (NANBNE) hepatitis. Of a total of 10 maternal deaths, 9 occurred (7 during the third trimester) in the pregnant group, 8 in association with HEV inf ection. Two deaths, one from each group, were due to NANBAE hepatitis. In addition to 6 foetal losses as a result of maternal death, there w ere 2 foetal deaths and 7 premature deliveries as a direct result of a cute viral hepatitis, all but 2 associated with HEV infection. Compari son of socioeconomic and nutritional status, clinical features, mean a minotransferase and bilirubin levels did not show differences in the t wo groups. Thus, pregnant women are more at risk to acquire HEV infect ion than nonpregnant women and HEV infection in this group of Ethiopia n pregnant women is associated with high maternal mortality and neonat al complications. The need for a readily available and inexpensive ser ological test for HEV infection is obvious. There is also an urgent ne ed to study the possible predisposing factor(s) to HEV infection in pr egnancy and the pathogenesis leading to the high rate of maternal and neonatal death. However, in terms of prevention of HEV (and HAV) infec tion, there is no better alternative to vigorous nationwide public hea lth education with emphasis on personal and environmental hygiene.