title: Hepatitis E virus and neurological injury.
abstract: Hepatitis E is hyperendemic in many developing countries in Asia and Africa, and is caused by hepatitis E virus (HEV) genotypes 1 and 2, which are spread via the faecal-oral route by contaminated water. Recent data show that HEV infection is also endemic in developed countries. In such geographical settings, hepatitis E is caused by HEV genotypes 3 and 4, and is mainly a porcine zoonosis. In a minority of cases, HEV causes acute and chronic hepatitis, but infection is commonly asymptomatic or unrecognized. HEV infection is associated with a number of extrahepatic manifestations, including a range of neurological injuries. To date, 91 cases of HEV-associated neurological injury--most commonly, Guillain-Barré syndrome, neuralgic amyotrophy, and encephalitis/myelitis--have been reported. Here, we review the reported cases, discuss possible pathogenic mechanisms, and present our perspectives on future directions and research questions.
authors.affiliation: Royal Cornwall Hospital, University of Exeter, Penventinnie Lane, Truro TR1 3LJ, UK.|European Centre for Environment &Human Health, University of Exeter, Penventinnie Lane, Truro TR1 3LJ, UK.
authors.forename: Harry R
authors.initials: HR
authors.lastname: Dalton
authors.affiliation: Departments of Nephrology and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR-BMT, Université Paul Sabatier, 1 Avenue J. Poulhès, Toulouse Cedex 9, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.affiliation: Department of Neurology, Jeroen Bosch Ziekenhuis (JBZ), Henri Dunantstraat 1, 5223 GZ, 's-Hertogenbosch, Netherlands.
authors.forename: Jeroen J J
authors.initials: JJ
authors.lastname: van Eijk
authors.affiliation: Royal Cornwall Hospital, University of Exeter, Penventinnie Lane, Truro TR1 3LJ, UK.
authors.forename: Brendan N
authors.initials: BN
authors.lastname: Mclean
authors.affiliation: Department of Neurology, Pierre Paul Riquet Hospital, CHU Purpan, Place du Dr Baylac, 31059 Toulouse, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Cintas
authors.affiliation: Royal Cornwall Hospital, University of Exeter, Penventinnie Lane, Truro TR1 3LJ, UK.|European Centre for Environment &Human Health, University of Exeter, Penventinnie Lane, Truro TR1 3LJ, UK.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Bendall
authors.affiliation: Department of Neurology/Neuro-Immunology Erasmus MC, Erasmus MC, Afdeling Neurologie, Kamer EE 2287, Postbus 2040, 3000 CA Rotterdam, Netherlands.
authors.forename: Bart C
authors.initials: BC
authors.lastname: Jacobs
mesh_terms: D000818:Animals; D016751:Hepatitis E / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D016752:Hepatitis E virus; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy* / Q000821:virology*