PMID- 31828968
OWN - NLM
STAT- MEDLINE
DCOM- 20210104
LR  - 20210110
IS  - 2162-3279 (Electronic)
VI  - 10
IP  - 1
DP  - 2020 Jan
TI  - Hepatitis E virus-associated Guillain-Barre syndrome: Revision of the literature.
PG  - e01496
LID - 10.1002/brb3.1496 [doi]
LID - e01496
AB  - INTRODUCTION: The association between preceding infection of hepatitis E virus 
      (HEV) and Guillain-Barre syndrome (GBS) has been found for more than a decade, 
      while hepatitis E virus-associated Guillain-Barre syndrome (HEV-associated GBS) 
      still remains poorly understood. Initially discovered in 2000, the association 
      between GBS and HEV has been focused by neurologists increasingly. Five percent 
      of patients with GBS had preceding acute HEV infection in the Netherlands and 
      higher rate was found in Bangladesh (11%) where HEV is endemic. METHOD: An 
      extensive review of relevant literature was undertaken. RESULTS: Hepatitis E 
      virus infection may induce GBS via direct viral damage according to recent 
      research findings. On the other hand, the presence of antiganglioside GM1 or GM2 
      antibodies in serum of some HEV-associated GBS patients indicates that HEV 
      infection may trigger GBS by activating autoimmune response to destroy myelin or 
      axon mistakenly. Management of HEV-associated GBS has no obvious difference from 
      GBS. It mainly consists of supportive therapy and immunotherapy. Intravenous 
      immunoglobulin (IVIG) or plasma exchange (PLEX) was used in most reported cases, 
      which is the main strategy for clinical treatment of HEV-associated GBS. Whether 
      antiviral therapy could be additional strategy other than the routine therapy to 
      shorten the length of disease course is one of the most urgent problems and 
      requires further study. CONCLUSIONS: An overview of possible pathogenesis will 
      gain a first insight into why HEV, traditionally recognized as only hepatotropic, 
      can induce many neurological disorders represented by GBS. Moreover, 
      understanding of the underlying mechanisms may contribute to development of a 
      novel therapeutic strategy. This review also summarizes management and clinical 
      characteristics of HEV-associated GBS, aiming to achieve early recognition and 
      good recovery.
CI  - (c) 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.
FAU - Liu, Hang
AU  - Liu H
AD  - Department of Neurology, Shengjing Hospital, China Medical University, Shenyang, 
      China.
FAU - Ma, Ying
AU  - Ma Y
AUID- ORCID: 0000-0001-7611-597X
AD  - Department of Neurology, Shengjing Hospital, China Medical University, Shenyang, 
      China.
LA  - eng
GR  - 81200834/National Nature Science Foundation for Young Scholars of 
      China/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20191211
PL  - United States
TA  - Brain Behav
JT  - Brain and behavior
JID - 101570837
SB  - IM
MH  - Autoimmunity
MH  - Disease Management
MH  - *Guillain-Barre Syndrome/etiology/virology
MH  - *Hepatitis E/complications/immunology
MH  - Hepatitis E virus/immunology/pathogenicity
MH  - Humans
PMC - PMC6955827
OTO - NOTNLM
OT  - Guillain-Barre syndrome
OT  - antiganglioside antibodies
OT  - extrahepatic manifestations
OT  - hepatitis E virus
OT  - infections
OT  - peripheral neuropathies
OT  - viral replication
COIS- The authors declare no financial or other conflict of interests.
EDAT- 2019/12/13 06:00
MHDA- 2021/01/05 06:00
PMCR- 2019/12/11
CRDT- 2019/12/13 06:00
PHST- 2019/09/05 00:00 [received]
PHST- 2019/11/12 00:00 [revised]
PHST- 2019/11/16 00:00 [accepted]
PHST- 2019/12/13 06:00 [pubmed]
PHST- 2021/01/05 06:00 [medline]
PHST- 2019/12/13 06:00 [entrez]
PHST- 2019/12/11 00:00 [pmc-release]
AID - BRB31496 [pii]
AID - 10.1002/brb3.1496 [doi]
PST - ppublish
SO  - Brain Behav. 2020 Jan;10(1):e01496. doi: 10.1002/brb3.1496. Epub 2019 Dec 11.