Physiological Dysregulations Associated with Hepatitis E Virus Infection in Pregnant Women: An Analytical Study of Pathogenic Mechanisms and Elevated Maternal Mortality Risk

This study was meant to investigate the mechanistic factors behind HEV infection causing severe clinical disease in pregnancy, targeting immune, hormonal, coagulation, and placental parameters in a case-control design with 77 HEV-infected pregnant women and 77 matched healthy controls in Iraq (January-December 2024 ). Sought were cytokine profiles (IFN-γ, IL-4, IL-10, TNF-α) and immune cell subsets (e.g., regulatory T cells), serum estradiol, progesterone, and cortisol concentrations; coagulation markers (PT, aPTT, D-dimer, fibrinogen). Laboratory investigations included ELISA kits for anti-HEV IgM/IgG; qualitative real-time PCR; multiplex cytokine assays; flow cytometry; hormone ELISAs; coagulation panels on an automated analyser.