Determination of Progesterone Levels in Hev Sero-Positive Pregnant Women Of Low Socio Economic Status

Abstract

Hepatitis E virus (HEV) infection is endemic in developing countries including Pakistan and it leads to fulminant hepatic failure (FHF) and high mortality in pregnant women. An altered status of hormones and immunity are observed during pregnancy but the actual cause of high mortality is still unknown .The present study was carried out to assay progesterone levels in the HEV IgG sero-positive pregnant women population of low socio economic status. Total 91 pregnant females from Rawalpindi district were recruited for the study. Serological tests for IgG and IgM against HEV were performed using ELISA kits .Hormone assay was performed on all samples by commercially available RIA kit. Out of 91 patients, 54 were found positive for the IgG and 9 were found positive for IgM presence. Alteration of levels of progesterone from normal level was observed in all the trimesters of pregnancy. High levels of progesterone were observed during the first trimester and extreme low levels were observed during the 2nd and 3rd trimester. Levels of progesterone were found to be higher (P < 0.001) in HEV IgM positive pregnant patients when compared to HEV IgG positive patients. It can be attributed from the study that presence of HEV-IgG and HEV-IgM appears to be associated with altered levels of progesterone in women of low socioeconomic status. Poor nutritional and environmental conditions are potential risk factor associated with alterations in the normal hormonal level observed in pregnancy. These alterations may serve as a reason for high mortality rate seen in HEV positive pregnant females