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      An update of the incidence of fulminant hepatitis due to viral agents during pregnancy

      review-article
      1 , *
      Interventional Medicine & Applied Science
      Akadémiai Kiadó
      fulminant hepatic, pregnant women, viral, liver

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          Abstract

          Fulminant hepatitis in pregnant women is one of the major public health issues and remains a challenging clinical problem with extremely high maternal and fetal morbidity and mortality, which, in parallel, viral factors are the most common cause of hepatic disorders and dysfunction during pregnancy that may lead to fulminant hepatic with a fast progression. Therefore, this review helps to inform clinicians about the current status of the incidence of fulminant hepatitis due to viral agents during pregnancy.

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          Most cited references39

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          Hepatitis E: an overview and recent advances in clinical and laboratory research.

          Hepatitis E virus (HEV) is a non-enveloped RNA (7.5 kb) virus that is responsible for large epidemics of acute hepatitis and a proportion of sporadic hepatitis cases in southeast and central Asia, the Middle East, parts of Africa and Mexico. Hepatitis E virus infection spreads by the faecal-oral route (usually through contaminated water) and presents after an incubation period of 8-10 weeks with a clinical illness resembling other forms of acute viral hepatitis. Clinical attack rates are the highest among young adults. Asymptomatic and anicteric infections are known to occur. Chronic HEV infection is not observed. Although the mortality rate is usually low (0.07-0.6%), the illness may be particularly severe among pregnant women, with mortality rates reaching as high as 25%. Recent isolation of a swine virus resembling human HEV has opened the possibility of zoonotic HEV infection. Studies of pathogenetic events in humans and experimental animals reveal that viral excretion begins approximately 1 week prior to the onset of illness and persists for nearly 2 weks; viraemia can be detected during the late phase of the incubation period. Immunoglobulin M antibody to HEV (anti-HEV) appears early during clinical illness but disappears rapidly over a few months. Immunoglobulin G anti-HEV appears a few days later and persists for at least a few years. There is no specific treatment available for hepatitis E virus infection. Ensuring a clean drinking water supply remains the best preventive strategy. Recombinant vaccines are being developed that may be particularly useful for travellers to disease-endemic areas and for pregnant women.
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            Soluble CD163 from activated macrophages predicts mortality in acute liver failure.

            Soluble CD163 (sCD163) is a scavenger receptor shed in serum during inflammatory activation of macrophages. We investigated if sCD163 was increased and predicted outcome in acute liver failure (ALF). Samples from 100 consecutive patients enrolled in the U.S. ALF Study Group for whom sera were available were collected on days 1 and 3, and clinical data were obtained prospectively. sCD163 levels were determined by ELISA. The median level of sCD163 was significantly increased in ALF (21.1mg/l (range 3.6-74.9)) as compared to healthy controls (2.3mg/l (0.65-5.6), p 26mg/l) of sCD163 was significantly correlated with fatal outcome and might be used with other parameters to determine prognosis.
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              Epidemiology of hepatitis E virus infection.

              M Balayan (1997)
              Hepatitis E is an acute, icteric, self-limiting disease, which is spread widely in many tropical and subtropical countries where it occurs both in the form of epidemics of variable magnitude or sporadically. Hepatitis E affects young adults, rather than children, and causes a high mortality rate, particularly in pregnant women. In industrialized countries this disease occurs occasionally as imported sporadic cases. The aetiological cause of hepatitis E is a virus, hepatitis E virus (HEV), which is temporally classified as a member of the Calicivirus family, although its genomic composition is unique. There are experimental data as well as epidemiological observations allowing us to assume that hepatitis E may be a zoonosis as HEV is pathogenic for some domestic and wild animals. Recently, serological assays based on the use of recombinant or synthetic antigens were developed and applied to determine the prevalence of antibody to HEV (anti-HEV) in various epidemic and non-epidemic settings. In suspected hepatitis E cases, anti-HEV seropositivity was detected at an elevated rate but the overall seroprevalence of anti-HEV in normal human populations of endemic areas appeared to be unexpectedly low. A low but constant presence of anti-HEV seropositivity was observed also in non-endemic industrialized countries. In some of these countries, anti-HEV seropositivity was accumulated in groups of patients with various liver and non-liver pathologies and certain groups at risk for blood-borne infections.
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                Author and article information

                Journal
                Interv Med Appl Sci
                Interv Med Appl Sci
                imas
                IMAS
                Interventional Medicine & Applied Science
                Akadémiai Kiadó (Budapest )
                2061-1617
                2061-5094
                26 September 2018
                December 2018
                : 10
                : 4
                : 210-212
                Affiliations
                [1 ]Department of Gynecology, Khanevadeh Hospital, AJA University of Medical Sciences , Tehran, Iran
                Author notes
                [* ]Corresponding author: Mehri Seifoleslami; Department of Gynecology, Khanevadeh Hospital, AJA University of Medical Sciences, Tehran 1434893868, Iran; Phone: +98 91 2154 0069; Fax: +98 91 7750 9348; E-mail: mehri_seifoleslami@ 123456yahoo.com.sg
                Article
                10.1556/1646.10.2018.40
                6376349
                85514711-9cb3-4665-abbc-5ed6e96237a8
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 01 June 2018
                : 11 July 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 3
                Funding
                Funding sources: None.
                Categories
                Review

                fulminant hepatic,pregnant women,viral,liver
                fulminant hepatic, pregnant women, viral, liver

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