Global seroprevalence of anti-HEV antibodies in pregnant women: a systematic meta-analysis

Résumé

Introduction. Hepatitis E virus (HEV) poses a notable risk to pregnant women, being linked to severe maternal and fetal complications. This meta-analysis assesses the global seroprevalence of anti-HEV IgG and IgM antibodies in this population.
Materials and Methods. A systematic review and meta-analysis were conducted according to PRISMA standards, including 30 observational studies from PubMed, Scopus, and Web of Science. HEV seroprevalence data were extracted and analyzed using a random-effects model. Heterogeneity was assessed with Cochran’s Q and I², while publication bias was examined through funnel plots and Egger’s test.
Results. Thirty studies from diverse regions were included. The pooled global seroprevalence of anti-HEV IgG was 14.68% (95% CI: 9.79–19.58), with the highest values reported in Pakistan (60.0%) and Ethiopia (42.4%), and the lowest in Croatia (1.7%). Anti-HEV IgM prevalence, reflecting recent infection, was 2.36% (95% CI: 0.86–3.85), with peak levels in Nigeria (15.0%) and Pakistan (13.3%). Substantial heterogeneity was observed (I² = 96.42% for IgG; I² = 94.25% for IgM), indicating major regional differences in exposure, sanitation, and diagnostic practices. No strong publication bias was identified (Egger p > 0.05).
Conclusions. HEV seroprevalence varies widely worldwide, with higher rates in areas lacking adequate sanitation. Strengthened surveillance, standardized diagnostics, and preventive strategies, including vaccination, are necessary to reduce risks among pregnant women.
Keywords: HEV; IgG; IgM; seroprevalence; pregnancy.