@article{d327fcf17d5647dda077c24759aa0a59,
title = "Arsenic exposure and hepatitis E virus infection during pregnancy",
abstract = "Background: Arsenic has immunomodulatory properties and may have the potential to alter susceptibility to infection in humans. Objectives: We aimed to assess the relation of arsenic exposure during pregnancy with immune function and hepatitis E virus (HEV) infection, defined as seroconversion during pregnancy and postpartum. Methods: We assessed IgG seroconversion to HEV between 1st and 3rd trimester (TM) and 3 months postpartum (PP) among 1100 pregnancies in a multiple micronutrient supplementation trial in rural Bangladesh. Forty women seroconverted to HEV and were matched with 40 non-seroconverting women (controls) by age, parity and intervention. We assessed urinary inorganic arsenic plus methylated species (∑As) (μg/L) at 1st and 3rd TM and plasma cytokines (pg/mL) at 1st and 3rd TM and 3 months PP. Results: HEV seroconverters' urinary ∑As was elevated throughout pregnancy. Non-seroconverters' urinary ∑As was similar to HEV seroconverters at 1st TM but declined at 3rd TM. The adjusted odds ratio (95% confidence interval) of HEV seroconversion was 2.17 (1.07, 4.39) per interquartile range (IQR) increase in average-pregnancy urinary ∑As. Increased urinary ∑As was associated with increased concentrations of IL-2 during the 1st and 3rd TM and 3 months PP among HEV seroconverters but not non-seroconverters. Conclusions: The relation of urinary arsenic during pregnancy with incident HEV seroconversion and with IL-2 levels among HEV-seroconverting pregnant women suggests arsenic exposure during pregnancy may enhance susceptibility to HEV infection.",
keywords = "Arsenic, Cytokines, Hepatitis E virus, Immunotoxicity, Infection, Pregnancy",
author = "Heaney, {Christopher D.} and Brittany Kmush and Ana Navas-Acien and Kevin Francesconi and Walter G{\"o}ssler and Kerry Schulze and DeLisa Fairweather and Sucheta Mehra and Nelson, {Kenrad E.} and Klein, {Sabra L.} and Wei Li and Hasmot Ali and Saijuddin Shaikh and Merrill, {Rebecca D.} and Lee Wu and West, {Keith P.} and Parul Christian and Labrique, {Alain B.}",
note = "Funding Information: This work was funded by the Johns Hopkins Center in Urban Environmental Health Translational Pilot Project Award ( National Institute of Environmental Health Sciences P30ES003819 ). CDH was supported by a K01 award from the National Institute for Occupational Safety and Health ( 1K01OH010193-01A1 ) and an E.W. “Al{"} Thrasher award (10287) from Thrasher Research Fund. DF was supported by the National Heart, Lung, and Blood Institute ( R01 HL111938 ). AN-A was supported by the National Institute of Environmental Health Sciences ( R01ES021367 ). The field trial and associated studies were supported through Grant 614 ( Global Control of Micronutrient Deficiency ) from the Bill and Melinda Gates Foundation, Seattle WA (Dr. Ellen Piwoz, Senior Program Officer); and through additional support from the Sight and Life Global Nutrition Research Institute, Baltimore, MD; DSM N.V., Kaiseraugst, Switzerland Bombay, India and Singapore formulated, prepared and delivered in-country micronutrient premixes for supplement production and Beximco Pharmaceuticals, Ltd., Dhaka produced, bottled, labeled and delivered tablets during the trial, both gratis; the Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka; and National Institute of Allergy and Infectious Diseases R56 award number AI068813-01A2. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2015 Elsevier Inc.",
year = "2015",
month = oct,
day = "1",
doi = "10.1016/j.envres.2015.07.004",
language = "English (US)",
volume = "142",
pages = "273--280",
journal = "Environmental Research",
issn = "0013-9351",
publisher = "Academic Press Inc.",
}