Seroprevalence and Molecular Epidemiology of Hepatitis E Virus Among Pregnant Women in Rural Kogi State

Hepatitis E virus (HEV) causes a particularly severe form of acute viral hepatitis during pregnancy, with fulminant hepatic failure rates approaching 25 percent in the third trimester in endemic settings. Despite this recognized risk, HEV remains poorly characterized in Nigerian pregnant populations. This cross-sectional molecular epidemiological study determined HEV seroprevalence and characterized circulating genotypes among pregnant women attending rural primary health centres in Ijumu and Kabba-Bunu local government areas of Kogi State, in the North Central geopolitical zone of Nigeria. Serum samples from 300 pregnant women were tested for anti-HEV IgG and IgM by ELISA. IgM-positive samples underwent RT-PCR for HEV RNA detection and phylogenetic genotype characterization. Anti-HEV IgG seroprevalence was 22.7 percent, indicating substantial prior exposure. Active infection (IgM positivity) was detected in 4.3 percent, with HEV RNA confirmed in 3.7 percent. Phylogenetic analysis placed all HEV RNA-positive samples within genotype 1, the most clinically dangerous genotype in pregnancy. Third trimester women had the highest rate of active HEV infection. These findings document significant HEV transmission in rural Kogi State and underscore the need for HEV inclusion in antenatal screening protocols, national epidemiological surveillance, and investigation of waterborne transmission pathways in the North Central zone. Keywords: hepatitis E virus, seroprevalence, pregnancy, Kogi State, genotype 1.