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Hepatitis E virus infection in acute non-traumatic neuropathy: A large prospective case-control study in China

机译：急性非创伤性神经病变中的戊型肝炎病毒感染：中国的一项大型前瞻性病例对照研究

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Neurological manifestations are potentially associated with hepatitis E virus (HEV) infection in Europe, mainly attributed to genotype (GT) 3 HEV infection. In this study, we determined the frequency and causal relationship of HEV in patients with non-traumatic neurological disorders in China, where GT4 HEV is prevalent. 1117 consecutive patients diagnosed with neurological illnesses in a hospital of eastern China and 1475 healthy controls who took routine examination in the same hospital were tested for HEV by serology and molecular methods. Anti-HEV IgM antibodies were detectable in 6 (0.54%) of the patients and 10 (0.68%) of the healthy controls ( P =?0.651). Serum HEV RNA was detected in all of the 16 individuals with positive anti-HEV IgM. The six patients with HEV infection included two viral encephalitis, two posterior circulation ischemia, one peripheral neuropathy and one Guillian-Barré syndrome. They had no symptoms of acute viral hepatitis except two patients of viral encephalitis that showed mildly transaminitis. Additional, 39.51% patients and 35.63% controls without acute HEV infection were positive for anti-HEV IgG ( P =?0.144). Anti-HEV IgG positivity was more frequent in male and elderly in both the patients and control groups, but unrelated to the incidence of any non-traumatic neurological illness, hospital stay or treatment outcome, except linking to better outcome of hemorrhagic stroke disease. These data demonstrated that HEV appears not to contribute to acute neurological disorders in China. Nevertheless, we cannot exclude a possible causative role, suggesting that testing HEV in this population, especially in situations of unexplained deregulated liver function would be warranted.
机译：在欧洲，神经系统疾病表现可能与戊型肝炎病毒（HEV）感染有关，主要归因于基因型（GT）3 HEV感染。在这项研究中，我们确定了GT4 HEV流行的中国非创伤性神经系统疾病患者中HEV的频率和因果关系。通过血清学和分子方法对在华东一家医院中连续被诊断出神经系统疾病的1117名患者和在同一家医院进行常规检查的1475名健康对照者进行了戊型肝炎病毒检测。抗HEV IgM抗体在6例（0.54％）患者和10例（0.68％）健康对照者中检出（P =？0.651）。抗HEV IgM阳性的16个人中均检测到血清HEV RNA。 6例HEV感染患者包括2例病毒性脑炎，2例后循环缺血，1例周围神经病变和1例Guillian-Barré综合征。他们没有急性病毒性肝炎的症状，只有两名病毒性脑炎患者表现为轻度转氨性。另外，没有急性HEV感染的39.51％的患者和35.63％的对照者的抗HEV IgG阳性（P =？0.144）。在患者和对照组中，男性和老年人中抗HEV IgG阳性率更高，但与任何非创伤性神经系统疾病，住院或治疗结果的发生率无关，除非与出血性中风疾病的更好结果相关。这些数据表明，戊型肝炎似乎并没有导致中国的急性神经系统疾病。然而，我们不能排除可能的致病作用，这表明在此人群中进行HEV检测，尤其是在无法解释的肝功能失调的情况下，是有必要的。

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