The association of cytokines and micronutrients with hepatitis e virus infection during pregnancy and the postpartum period in rural Bangladesh

Brittany L. Kmush, Alain Labrique, Wei Li, Sabra L. Klein, Kerry Schulze, Saijuddin Shaikh, Hasmot Ali, Ronald E. Engle, Lee Wu, Robert H. Purcell, Sucheta Mehra, Parul Christian, Keith West, Kenrad Nelson

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Hepatitis E virus (HEV) infection is severe during pregnancy, with a pregnant case fatality rate around 30%. In Bangladesh, plasma samples from 1,100 women during the first trimester (TM) and third TM of pregnancy and 3 months postpartum (PP) were tested for anti-HEV IgG. During this time, 40 women developed antibody responses to HEV. These seroconverters are classified as the cases (incidence = 46 infections per 1,000 personyears). All except one seroconversion occurred between the third TM and 3 months PP. The cases and 40 matched non-seroconverters (controls) underwent analysis of a panel of 10 cytokines, 12 vitamins and minerals, and two markers of inflammation. Throughout pregnancy, seroconverting cases displayed higher concentrations of both pro-and anti-inflammatory cytokines compared with the non-seroconverting controls, even prior to infection. In the first TM, seroconverters had lower circulating zinc concentrations (P = 0.03), an increased prevalence of vitamin D deficiency (25-hydroxy vitamin D [25(OH)2D] <50 nmol/L, P = 0.08), and anemia (hemoglobin <110 g/L, P = 0.05) compared with controls. There were no differences in C-reactive protein or á-1-acid glycoprotein. Antecedent micronutrient deficiencies may lead to dysregulated cytokine expression and immunologic compromise, increasing the risk of HEV infection, especially during pregnancy. This exploratory analysis reveals potential novel associations that deserve further study.

Original languageEnglish (US)
Pages (from-to)203-211
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume94
Issue number1
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

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    Kmush, B. L., Labrique, A., Li, W., Klein, S. L., Schulze, K., Shaikh, S., Ali, H., Engle, R. E., Wu, L., Purcell, R. H., Mehra, S., Christian, P., West, K., & Nelson, K. (2016). The association of cytokines and micronutrients with hepatitis e virus infection during pregnancy and the postpartum period in rural Bangladesh. American Journal of Tropical Medicine and Hygiene, 94(1), 203-211. https://doi.org/10.4269/ajtmh.15-0238