Prevalence of hepatitis E virus in pregnant women in Northeast Brazil

Hepatitis E virus (HEV) infection remains underrecognized in many low- and middle-income settings, particularly among pregnant women, a population potentially vulnerable to adverse maternal and fetal outcomes. We investigated HEV seroprevalence, molecular detection, and epidemiological characteristics among pregnant women attending antenatal care services in northeastern Brazil. Serum samples from 900 pregnant women were screened for anti-HEV IgG. Reactive samples were further tested for anti-HEV IgM using two commercial immunoassays and for HEV RNA by real-time reverse transcription polymerase chain reaction (RT-qPCR). Demographic, environmental, and obstetric variables were analyzed using appropriate statistical tests. Anti-HEV IgG was detected in two pregnant women (0.22%; 2/900), whereas no samples were positive for anti-HEV IgM. Both IgG-positive women tested positive for HEV RNA by RT-qPCR, were asymptomatic at the time of sampling, and reported exposure profiles compatible with recognized fecal-oral transmission routes. No statistically significant associations were observed between HEV positivity and the variables evaluated. This study reports the seroprevalence and molecular detection of HEV among pregnant women attending antenatal care services in northeastern Brazil. Beyond providing epidemiological data, these findings highlight the importance of combining serological and molecular approaches for HEV investigation and reinforce the need for further epidemiological studies to better define the public health relevance of HEV infection during pregnancy. Not applicable.