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Serum tumor necrosis factor‐alpha level in hepatitis E virus‐related acute viral hepatitis and fulminant hepatic failure in pregnant women
Author(s) -
Salam Gyaneshwori Devi,
Kumar Ashok,
Kar Premashis,
Aggarwal Sarita,
Husain Akhtar,
Sharma Shashi
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12028
Subject(s) - hepatitis e virus , medicine , asymptomatic , fulminant hepatic failure , pregnancy , viral hepatitis , hepatitis e , fulminant , tumor necrosis factor alpha , jaundice , immunology , hepatitis , gastroenterology , liver transplantation , transplantation , biology , biochemistry , genetics , gene , genotype
Aim The host response in hepatitis E virus ( HEV )‐related liver disease of pregnant women is unclear. This study was carried out to evaluate the serum concentration of tumor necrosis factor ( TNF )‐α in HEV ‐related acute viral hepatitis ( AVH ) and fulminant hepatic failure ( FHF ) in pregnant women in relation to pregnancy outcome. Methods The study included 262 pregnant and 158 non‐pregnant women with jaundice. There were 160 healthy asymptomatic pregnant women and 124 healthy asymptomatic non‐pregnant women as controls. The jaundiced patients were classified as AVH or FHF . Serum TNF ‐α level was assayed by commercially available enzyme‐linked immunoassay kits. Results A significantly higher level of TNF ‐α was observed in HEV ‐infected pregnant women than non‐ HEV pregnant women ( P < 0.001). TNF ‐α level was significantly higher in AVH and FHF of HEV ‐infected pregnant women compared with AVH and FHF of HEV infected non‐pregnant women ( P = 0.036 and P = 0.010, respectively). The HEV ‐infected pregnant FHF expired group had significantly higher levels of TNF ‐α than the non‐pregnant FHF expired group ( P = 0.025). TNF ‐α levels were significantly higher in AVH of HEV ‐infected pregnant women than healthy pregnant controls ( P < 0.001). Higher TNF ‐α levels were observed in HEV ‐infected women having preterm delivery and low birthweight newborns compared with non‐ HEV and healthy pregnant women. Conclusion Higher serum concentration of TNF ‐α observed in HEV infected AVH and FHF pregnant cases shows that pregnancy with HEV infection increases TNF ‐α secretion. TNF ‐α may be an important factor in the outcomes of pregnancy due to HEV infection.