Serological indication of chronic inflammatory demyelinating polyneuropathy as an extrahepatic manifestation of hepatitis E virus infection

Sci Rep. 2024 Aug 20;14(1):19244. doi: 10.1038/s41598-024-70104-3.

Abstract

Guillain-Barré syndrome and neuralgic amyotrophy have been associated with hepatitis E virus (HEV) genotype 3 infections, while myasthenia gravis (MG) has been associated with HEV genotype 4 infections. However, whether chronic inflammatory demyelinating polyneuropathy (CIDP) is associated with HEV infections has not been conclusively clarified yet. 102 CIDP patients, 102 age- and sex-matched blood donors, 61 peripheral neuropathy patients (non-CIDP patients), and 26 MG patients were tested for HEV and anti-HEV IgM and IgG. Sixty-five of the 102 (64%) CIDP patients tested positive for anti-HEV IgG and one (1%) for anti-HEV IgM. No other patient tested positive for ati-HEV IgM. In the subgroup of CIDP patients with initial diagnosis (without previous IVIG treatment), 30/54 (56%) tested positive for anti-HEV IgG. Anti-HEV rates were significantly lower in blood donors (28%), non-CIDP peripheral neuropathy patients (20%), and MG patients (12%). No subject tested positive for HEV viremia. CSF tested negative for in 61 CIDP patients (54 patients with primary diagnosis). The development of CIDP but not non-CIDP polyneuropathy may be triggered by HEV exposure in an HEV genotype 3 endemic region. The increased anti-HEV seroprevalence in CIDP patients is not a consequence of IVIG therapy.

Keywords: Anti-HEV-IgG; CIDP; HEV; Hepatitis E; Myasthenia gravis.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hepatitis Antibodies / blood
  • Hepatitis E virus* / immunology
  • Hepatitis E* / blood
  • Hepatitis E* / complications
  • Hepatitis E* / immunology
  • Humans
  • Immunoglobulin G* / blood
  • Immunoglobulin M* / blood
  • Male
  • Middle Aged
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / blood
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating* / immunology

Substances

  • Immunoglobulin G
  • Immunoglobulin M
  • Hepatitis Antibodies