Hepatitis E, a vaccine-preventable cause of maternal deaths

Alain B Labrique, Shegufta S Sikder, Lisa J Krain, Keith P West Jr, Parul Christian, Mahbubur Rashid, Kenrad E Nelson, Alain B Labrique, Shegufta S Sikder, Lisa J Krain, Keith P West Jr, Parul Christian, Mahbubur Rashid, Kenrad E Nelson

Abstract

Hepatitis E virus (HEV) is a major cause of illness and of death in the developing world and disproportionate cause of deaths among pregnant women. Although HEV vaccine trials, including trials conducted in populations in southern Asia, have shown candidate vaccines to be effective and well-tolerated, these vaccines have not yet been produced or made available to susceptible populations. Surveillance data collected during 2001-2007 from >110,000 pregnancies in a population of ≈650,000 women in rural Bangladesh suggest that acute hepatitis, most of it likely hepatitis E, is responsible for ≈9.8% of pregnancy-associated deaths. If these numbers are representative of southern Asia, as many as 10,500 maternal deaths each year in this region alone may be attributable to hepatitis E and could be prevented by using existing vaccines.

References

    1. World Health Organization. Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases. WHO/HTM/NTD/2010.1. Geneva: The Organization; 2010.
    1. Balayan MS, Andjaparidze AG, Savinskaya SS, Ketiladze ES, Braginsky DM, Savonov AP, et al. Evidence for a virus in non-A, non-B hepatitis transmitted via the fecal-oral route. Intervirology. 1983;20:23–31. 10.1159/000149370
    1. Reyes GR, Yarbough PO, Tam AW, Purdy MA, Huang CC, Kim JS, et al. Hepatitis E virus (HEV): the novel agent responsible for enterically transmitted non-A, non-B hepatitis. Gastroenterol Jpn. 1991;26(Suppl 3):142–7.
    1. Khuroo MS. Discovery of hepatitis E: the epidemic non-A, non-B hepatitis 30 years down the memory lane. Virus Res. 2011;161:3–14. 10.1016/j.virusres.2011.02.007
    1. Labrique AB, Thomas DL, Stoszek SK, Nelson KE. Hepatitis E: an emerging infectious disease. Epidemiol Rev. 1999;21:162–79. 10.1093/oxfordjournals.epirev.a017994
    1. Viswanathan R. Certain epidemiological features of infectious hepatitis during the Delhi epidemic, 1955–1956. In: Hartman FW, LoGrippo GA, Matffer JG, Barron J, editors. Hepatitis frontiers. Boston: Little, Brown and Company; 1957. p. 207–10.
    1. Rein DB, Stevens G, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus. Hepatology. 2012;55:988–97. 10.1002/hep.25505
    1. Labrique AB, Zaman K, Hossain Z, Saha P, Yunus M, Hossain A, et al. Population seroprevalence of hepatitis E virus antibodies in rural Bangladesh. Am J Trop Med Hyg. 2009;81:875–81. 10.4269/ajtmh.2009.09-0352
    1. Labrique AB, Zaman K, Hossain Z, Saha P, Yunus M, Hossain A, et al. Epidemiology and risk factors of incident hepatitis E virus infections in rural Bangladesh. Am J Epidemiol. 2010;172:952–61. 10.1093/aje/kwq225
    1. Drobeniuc J, Meng J, Reuter G, Greene-Montfort T, Khudyakova N, Dmitrova Z, et al. Serologic assays specific to immunoglobulin M antibodies against hepatitis E virus: pangenotypic evaluation of performances. Clin Infect Dis. 2010;51:e24–7. 10.1086/654801
    1. Mast EE, Alter MJ, Holland PV, Purcell RH. Evaluation of assays for antibody to hepatitis E virus by a serum panel. Hepatology. 1998;27:857–61. 10.1002/hep.510270331
    1. Safary A. Perspectives of vaccination against hepatitis E. Intervirology. 2001;44:162–6. 10.1159/000050043
    1. Shrestha MP, Scott RM, Joshi DM, Mammen MP Jr, Thapa N, Myint KS, et al. Safety and efficacy of a recombinant hepatitis E vaccine. N Engl J Med. 2007;356:895–903. 10.1056/NEJMoa061847
    1. Andrews J. Military sponsored vaccine trials and la resistance in Nepal. Am J Bioeth. 2005;5:W1–3. 10.1080/15265160591002962
    1. Basu S, Lurie P. Hepatitis E vaccine. N Engl J Med. 2007;356:2421–2. 10.1056/NEJMc070884
    1. Stevenson P. Nepal calls the shots in hepatitis E virus vaccine trial. Lancet. 2000;355:1623. 10.1016/S0140-6736(05)72531-9
    1. Dalton HR, Bendall R, Ijaz S, Banks M. Hepatitis E: an emerging infection in developed countries. Lancet Infect Dis. 2008;8:698–709. 10.1016/S1473-3099(08)70255-X
    1. Purcell RH, Emerson SU. Hepatitis E: an emerging awareness of an old disease. J Hepatol. 2008;48:494–503. 10.1016/j.jhep.2007.12.008
    1. Teo CG. Much meat, much malady: changing perceptions of the epidemiology of hepatitis E. Clin Microbiol Infect. 2010;16:24–32. 10.1111/j.1469-0691.2009.03111.x
    1. Kuniholm MH, Purcell RH, McQuillan GM, Engle RE, Wasley A, Nelson KE. Epidemiology of hepatitis E virus in the United States: results from the Third National Health and Nutrition Examination Survey, 1988–1994. J Infect Dis. 2009;200:48–56. 10.1086/599319
    1. Zhu FC, Zhang J, Zhang XF, Zhou C, Wang ZZ, Huang SJ, et al. Efficacy and safety of a recombinant hepatitis E vaccine in healthy adults: a large-scale, randomised, double-blind placebo-controlled, phase 3 trial. Lancet. 2010;376:895–902. 10.1016/S0140-6736(10)61030-6
    1. Yang L, ed. China approves hepatitis E vaccine. Xinhua News Agency, Beijing. January 11, 2012. [cited 2012 Jan 29].
    1. Pagliusi S. World’s first hepatitis E vaccine approved in China. WHO Global Immunization News. January 31, 2012. [cited 2012 May 7].
    1. Proffitt A. First HEV vaccine approved. Nat Biotechnol. 2012;30:300. 10.1038/nbt0412-300a
    1. Zhang M, Emerson SU, Nguyen H, Engle RE, Govindarajan S, Gerin JL, et al. Immunogenicity and protective efficacy of a vaccine prepared from 53 kDa truncated hepatitis E virus capsid protein expressed in insect cells. Vaccine. 2001;20:853–7. 10.1016/S0264-410X(01)00399-1
    1. Wu T, Zhu FC, Huang SJ, Zhang XF, Wang ZZ, Zhang J, et al. Safety of the hepatitis E vaccine for pregnant women: a preliminary analysis. Hepatology. 2012;55:2038. 10.1002/hep.25522
    1. West KP Jr, Christian P, Labrique AB, Rashid M, Shamim AA, Klemm RD, et al. Effects of vitamin A or beta carotene supplementation on pregnancy-related mortality and infant mortality in rural Bangladesh: a cluster randomized trial. JAMA. 2011;305:1986–95. 10.1001/jama.2011.656
    1. Labrique AB, Christian P, Klemm RD, Rashid M, Shamim AA, Massie A, et al. A cluster-randomized, placebo-controlled, maternal vitamin A or beta-carotene supplementation trial in Bangladesh: design and methods. Trials. 2011;12:102. 10.1186/1745-6215-12-102
    1. Klemm RD, Labrique AB, Christian P, Rashid M, Shammim AA, Katz J, et al. Newborn vitamin A supplementation reduced infant mortality in rural Bangladesh. Pediatrics. 2008;122:e242–50. 10.1542/peds.2007-3448
    1. Khatun F, Rasheed S, Moran AC, Alam AM, Shomik MS, Sultana M, et al. Causes of neonatal and maternal deaths in Dhaka slums: implications for service delivery. BMC Public Health. 2012;12:84. 10.1186/1471-2458-12-84
    1. Alam S, Azam G, Mustafa G, Azad AK, Haque I, Gani S, et al. Natural course of fulminant hepatic failure: the scenario in Bangladesh and the differences from the West. Saudi J Gastroenterol. 2009;15:229–33. 10.4103/1319-3767.56094
    1. Mahtab MA, Rahman S, Khan M, Karim F. HEV infection as an aetiologic factor for acute hepatitis: experience from a tertiary hospital in Bangladesh. J Health Popul Nutr. 2009;27:14–9.
    1. Sheikh A, Sugitani M, Kinukawa N, Moriyama M, Arakawa Y, Komiyama K, et al. Hepatitis E virus infection in fulminant hepatitis patients and an apparently healthy population in Bangladesh. Am J Trop Med Hyg. 2002;66:721–4.
    1. Streatfield PK, El Arifeen S, Al-Sabir A, Jamil K. Bangladesh maternal mortality and health care survey: summary of key findings and implications. Dhaka (Bangladesh): National Institute of Population Research and Training; 2010.
    1. World Health Organization. Trends in maternal mortality: 1990 to 2008. Geneva: The Organization; 2010.

Source: PubMed

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