Answer:

Hepatitis E is an acute liver disease caused by the hepatitis E virus (HEV), primarily transmitted through the fecal-oral route, particularly via contaminated water or food.

HEV comprises several genotypes, with genotypes one and two being the most common and mainly transmitted through contaminated water. HEV genotypes three and four can be transmitted through food, such as raw or undercooked pork, or from animals to humans.

After entering the body via the digestive tract, HEV replicates in the intestines before spreading to the liver, causing damage to liver cells through an immune response.

Most cases of hepatitis E resolve naturally within 2-6 weeks. However, the disease can lead to severe complications or be fatal in pregnant women and individuals with compromised immune systems. For pregnant women, especially during the second trimester (13-27 weeks) and third trimester (28-40 weeks), the disease carries a higher risk of severe progression, requiring close monitoring to prevent acute or fulminant liver failure.

You have not provided specific laboratory test results. If liver enzymes are significantly elevated compared to normal limits, or if you experience symptoms like jaundice, yellow eyes, severe fatigue, loss of appetite, right upper quadrant pain, fever, or persistent nausea, you should be hospitalized for monitoring and treatment. Doctors will assess liver and kidney function, coagulation status, and potential complications for both the mother and the fetus.

Doctor Thanh Quyt consults a patient. Illustration: Tam Anh General Hospital

Currently, there are no specific antiviral drugs routinely recommended for pregnant women with hepatitis E. Therefore, treatment mainly involves rest, ensuring adequate nutrition, hydration, symptomatic treatment, and managing any complications that arise. Monitoring typically requires coordination between hepatology and obstetrics specialists to ensure the safety of both mother and baby.

If liver enzymes are only mildly elevated, health is stable, and there are no unusual symptoms, you may be monitored as an outpatient under a doctor's guidance. Patients need regular follow-up appointments and liver function tests to assess disease progression and detect any abnormalities early.

Some of the most concerning complications of hepatitis E in pregnant women include acute liver failure, fulminant liver failure, coagulation disorders, postpartum hemorrhage, and an increased risk of mortality for both mother and fetus. Therefore, pregnant women require close monitoring throughout the illness.

Hepatitis E is usually an acute illness and does not become chronic in individuals with normal immune systems. After recovery, the body produces antibodies against the virus. However, the protective ability of these antibodies may decrease over time, so a person can still be reinfected with hepatitis E if exposed to the source in the future.

To prevent reinfection, you should consume thoroughly cooked food and boiled water, use clean water sources, wash hands frequently, and ensure food safety, especially during pregnancy.

Doctor, Level 2 Specialist Ngo Thi Thanh Quyt

Department of Gastroenterology - Hepatology - Pancreatology

Tam Anh General Hospital Ho Chi Minh City