A case of Japanese pregnant woman who developed severe acute hepatitis E right after back from India

Abstract

Hepatitis E virus (HEV) causes large-scale outbreaks in endemic areas and sporadic infections in developed countries: the latter includes "imported infection" by travelers back from endemic areas. In men and nonpregnant women, HEV infection is usually self-limited. It is reported, however, that acute hepatitis E in pregnant women is more severe, often resulting in fulminant hepatic failure. We experienced the first case of the pregnancy-associated acute hepatitis E in Japan: our patient was at 21st week of pregnancy and had stayed in India until 2 weeks before developing hepatitis. The HEV isolate recovered from her serum (JHN-Kan07R, AB447389) segregated to genotype 1, prevalent in India. Result of a predictive formula for development of fulminant hepatitis was positive on admission. Therefore we started daily administration of interferon and steroid pulse treatment, and the patient recovered rapidly. She was delivered of a baby without serious perinatal complications in spite of preterm delivery that is one of the reported obstetric complications of HEV infection. © 2009 The Japan Society of Hepatology.