Screening of hepatitis E in patients presenting for acute neurological disorders

J Infect Public Health. 2020 Jul;13(7):1047-1050. doi: 10.1016/j.jiph.2019.12.012. Epub 2020 Mar 26.

Abstract

Introduction: Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury.

Method: A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data on patients with acute (<3 months) non-traumatic, non-metabolic, non-vascular neurological injuries. Acute hepatitis E was defined as anti-HEV IgM-positive serum in immunocompetent patient, and as anti-HEV IgM-positive serum or HEV RNA-positive serum in immunocompromised patients.

Results: One hundred fifty-nine patients were included. Anti-HEV IgM seroprevalence in our cohort of non-traumatic, non-metabolic, non-vascular neurological injuries was 6.9% (eleven patients, including 4 Parsonage-Turner syndrome (PTS) and 2 Guillain-Barré syndrome (GBS)). Elevated transaminases were observed in only 64% of hepatitis E patients and cholestasis in 64%.

Conclusion: In this study, 6·9% of patients with acute non-traumatic, non-metabolic, non-vascular neurological injuries had a probable recent HEV infection. HEV serology should be systematically performed in this population, even in patients with normal transaminase level.

Keywords: Acute hepatitis; Hepatitis; Hepatitis E; Neurological disorder.

MeSH terms

  • Acute Disease / epidemiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Brachial Plexus Neuritis / epidemiology
  • Female
  • France / epidemiology
  • Guillain-Barre Syndrome / epidemiology
  • Hepatitis Antibodies / blood*
  • Hepatitis E / blood
  • Hepatitis E / diagnosis
  • Hepatitis E / epidemiology*
  • Hepatitis E / immunology
  • Hepatitis E virus / immunology*
  • Humans
  • Immunoglobulin M / blood
  • Male
  • Middle Aged
  • Nervous System Diseases / epidemiology*
  • Nervous System Diseases / immunology
  • Prospective Studies
  • RNA, Viral / blood
  • Reverse Transcriptase Polymerase Chain Reaction
  • Seroepidemiologic Studies
  • Transaminases / blood
  • Young Adult

Substances

  • Hepatitis Antibodies
  • Immunoglobulin M
  • RNA, Viral
  • Transaminases