Hepatitis E Virus and Neurologic Disorders

TLDR: During 2004-2009, among 126 patients with locally acquired acute and chronic HEV genotype 3 infection, neurologic complications developed in 7: inflammatory polyradiculopathy, Guillain-Barre syndrome, bilateral brachial neuritis, encephalitis, and ataxia/proximal myopathy.

Abstract: Information about the spectrum of disease caused by hepatitis E virus (HEV) genotype 3 is emerging During 2004-2009, at 2 hospitals in the United Kingdom and France, among 126 patients with locally acquired acute and chronic HEV genotype 3 infection, neurologic complications developed in 7 (55%): inflammatory polyradiculopathy (n = 3), Guillain-Barre syndrome (n = 1), bilateral brachial neuritis (n = 1), encephalitis (n = 1), and ataxia/proximal myopathy (n = 1) Three cases occurred in nonimmunocompromised patients with acute HEV infection, and 4 were in immunocompromised patients with chronic HEV infection HEV RNA was detected in cerebrospinal fluid of all 4 patients with chronic HEV infection but not in that of 2 patients with acute HEV infection Neurologic outcomes were complete resolution (n = 3), improvement with residual neurologic deficit (n = 3), and no improvement (n = 1) Neurologic disorders are an emerging extrahepatic manifestation of HEV infection