Maternal hepatitis E virus infection: Immunopathogenesis, genotype-specific severity, and vertical transmission dynamics

doi:10.4254/wjh.122717

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World Journal of Hepatology

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1948-5182

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World J Hepatol. Sep 27, 2026; 18(9): 122717
Published online Sep 27, 2026. doi: 10.4254/wjh.122717

Table 1 Genotype-specific characteristics of hepatitis E virus infection in pregnancy

Genotype	Host range	Transmission route	Geographic distribution	Maternal outcomes	Vertical transmission	Key features
HEV-1	Human-restricted	Fecal-oral (waterborne)	Asia (India, Pakistan, Bangladesh, and Nepal)	Fulminant hepatic failure, high mortality (15%-30%)	High (pooled transmission rate is 36.9% with a range from 33%-100%)	High placental tropism, strong cytokine response
HEV-2	Human-restricted	Fecal-oral	Africa, Central America	Similar to HEV-1 (FHF, fetal loss)	Moderate-high (limited evidence)	Less studied, similar epidemiology to HEV-1
HEV-3	Zoonotic	Foodborne (pork, animals)	Europe, North America, Asia East Asia	Usually asymptomatic or mild hepatitis	Not reported	Can cause chronic infection in immunocompromised; transfusion related
HEV-4	Zoonotic	Foodborne	Europe, North America, Asia East Asia	Generally mild disease in pregnancy	Rare	Rare, adverse pregnancy outcome; transfusion related

HEV: Hepatitis E virus; FHF: Fulminant hepatic failure.

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Citation: Sharma K, Pandey MK, Singh AK, Sikenis M, Prajapati B, Jothish A, Bhukya PL, Vyas AK, Simovic Markovic BJ, Corovic IF, Nema RK. Maternal hepatitis E virus infection: Immunopathogenesis, genotype-specific severity, and vertical transmission dynamics. World J Hepatol 2026; 18(9): 122717
URL: https://www.wjgnet.com/1948-5182/full/v18/i9/122717.htm
DOI: https://dx.doi.org/10.4254/wjh.122717

Sharma K, Pandey MK, Singh AK, Sikenis M, Prajapati B, Jothish A, Bhukya PL, Vyas AK, Simovic Markovic BJ, Corovic IF, Nema RK. Maternal hepatitis E virus infection: Immunopathogenesis, genotype-specific severity, and vertical transmission dynamics. World J Hepatol 2026; 18(9): 122717 [DOI: 10.4254/wjh.122717]

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