Neurological manifestations of hepatitis E virus infection: An overview

Abstract

Hepatitis E virus (HEV) is an important cause of repeated waterborne outbreaks of acute hepatitis. Recently, several extrahepatic manifestations (EHMs) have been described in patients with HEV infection. Of these, neurological disorders are the most common EHM associated with HEV. The involvement of both the peripheral nervous system and central nervous system can occur together or in isolation. Patients can present with normal liver function tests, which can often be misleading for physicians. There is a paucity of data on HEV-related neurological manifestations; and these data are mostly described as case reports and case series. In this review, we analyzed data of 163 reported cases of HEV-related neurological disorders. The mechanisms of pathogenesis, clinico-demographic profile, and outcomes of the HEV-related neurological disorders are described in this article. Nerve root and plexus disorder were found to be the most commonly reported disease, followed by meningoencephalitis.

Keywords: Acute hepatitis E; Extrahepatic manifestations; Guillain-Barré syndrome; Hepatitis E virus; Neuralgic amyotrophy; Neurological manifestations.

Figure 1

Schematic diagram demonstrating the potential mechanisms of extrahepatic manifestations of hepatitis E virus infection. HEV: Hepatitis E virus; IL: Interleukin.