Neurologic Disorders in Immunocompetent Patients with Autochthonous Acute Hepatitis E

Emerg Infect Dis. 2015 Nov;21(11):1928-34. doi: 10.3201/eid2111.141789.


Neurologic disorders, mainly Guillain-Barré syndrome and Parsonage–Turner syndrome (PTS), have been described in patients with hepatitis E virus (HEV) infection in industrialized and developing countries. We report a wider range of neurologic disorders in nonimmunocompromised patients with acute HEV infection. Data from 15 French immunocompetent patients with acute HEV infection and neurologic disorders were retrospectively recorded from January 2006 through June 2013. The disorders could be divided into 4 main entities: mononeuritis multiplex, PTS, meningoradiculitis, and acute demyelinating neuropathy. HEV infection was treated with ribavirin in 3 patients (for PTS or mononeuritis multiplex). One patient was treated with corticosteroids (for mononeuropathy multiplex), and 5 others received intravenous immunoglobulin (for PTS, meningoradiculitis, Guillain-Barré syndrome, or Miller Fisher syndrome). We conclude that pleiotropic neurologic disorders are seen in HEV-infected immunocompetent patients. Patients with acute neurologic manifestations and aminotransferase abnormalities should be screened for HEV infection.

Keywords: Guillain-Barré syndrome; HEV; Parsonage–Turner syndrome; demyelinating neuropathy; hepatitis E; hepatitis E virus; immunocompetent; meningoradiculitis; mononeuritis multiplex; neurologic disorders; neurological manifestations; viruses.

MeSH terms

  • Acute Disease / mortality*
  • Adult
  • Aged
  • Education, Medical, Continuing
  • Female
  • Hepatitis E / complications*
  • Hepatitis E / physiopathology
  • Humans
  • Immunocompetence*
  • Male
  • Middle Aged
  • Nervous System Diseases / etiology*
  • Nervous System Diseases / mortality