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

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

Research output: Contribution to journalArticle

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

Fingerprint

Hepatitis E virus
Hepatitis Viruses
Bangladesh
Micronutrients
Virus Diseases
Postpartum Period
Cytokines
Pregnancy
Third Pregnancy Trimester
First Pregnancy Trimester
Vitamin D Deficiency
Infection
Vitamin D
Vitamins
C-Reactive Protein
Antibody Formation
Minerals
Zinc
Anemia
Glycoproteins

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

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title = "The association of cytokines and micronutrients with hepatitis e virus infection during pregnancy and the postpartum period in rural Bangladesh",
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 {\'a}-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.",
author = "Kmush, {Brittany L.} and Labrique, {Alain B} and Wei Li and Klein, {Sabra L} and Schulze, {Kerry J} and Saijuddin Shaikh and Hasmot Ali and Engle, {Ronald E.} and Wu, {Lee Shu Fune} and Purcell, {Robert H.} and Sucheta Mehra and Christian, {Parul S} and Keith West and Nelson, {Kenrad Edwin}",
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AU - Labrique, Alain B

AU - Li, Wei

AU - Klein, Sabra L

AU - Schulze, Kerry J

AU - Shaikh, Saijuddin

AU - Ali, Hasmot

AU - Engle, Ronald E.

AU - Wu, Lee Shu Fune

AU - Purcell, Robert H.

AU - Mehra, Sucheta

AU - Christian, Parul S

AU - West, Keith

AU - Nelson, Kenrad Edwin

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