Neuropathies related to hepatitis E virus infection : a prospective, matched case–control study
Ripellino, Paolo
ORCID
Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Lascano, Agustina Maria Neurology Division, Department of Clinical Neuroscience, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Switzerland
Scheidegger, Olivier
ORCID
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland
Schilg-Hafer, LenkaDepartment of Neurology, Cantonal Hospital, St. Gallen, Switzerland
Schreiner, Bettina Department of Neurology, University and Hospital Zurich, Switzerland
Tsouni, PinelopiService de Neurologie, Hôpital du Valais, Sion, Switzerland
Vicino, Alex
ORCID
Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland
Humm, Andrea MonikaDepartment of Medicine, Neurology Unit, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland
Décard, Bernhard FriedrichDepartment of Neurology, University Hospital and University of Basel, Switzerland
Pianezzi, EneaLaboratory of Microbiology EOC, Bellinzona, Switzerland
Zezza, GiuliaLaboratory of Microbiology EOC, Bellinzona, Switzerland
Sparasci, Davide
ORCID
Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland
Hundsberger, ThomasDepartment of Neurology, Cantonal Hospital, St. Gallen, Switzerland
Dietmann, Anelia
ORCID
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland
Jung, HansDepartment of Neurology, University and Hospital Zurich, Switzerland
Kuntzer, ThierryNerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland
Wilder-Smith, EinarDepartment of Neurology, Inselspital, Bern University Hospital and University of Bern, Switzerland - Cantonal Hospital, Lucerne, Switzerland
Niederhauser, ChristophInterregional Blood Transfusion SRC, Bern, Switzerland - Institute for Infectious Diseases, University of Bern, Switzerland
Gobbi, Claudio
ORCID
Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
English
Background: acute hepatitis E virus (HEV) infection has recently emerged as a potential trigger for acute dysimmune neuropathies, but prospective controlled studies are lacking. Aims: to compare the frequency of concomitant acute HEV infection in patients with neuralgic amyotrophy (NA), Guillain–Barré syndrome (GBS), and Bell's palsy with a matched control population. Methods: Swiss multicenter, prospective, observational, matched case–control study over 3 years (September 2019–October 2022). Neurological cases with NA, GBS, or Bell's palsy were recruited within 1 month of disease onset. Healthy controls were matched for age, sex, geographical location, and timing of blood collection. Diagnostic criteria for acute hepatitis E were reactive serum anti-HEV IgM and IgG assays (ELISA test) and/or HEV RNA detection in serum by real-time polymerase chain reaction (RT-PCR). RT-PCR was performed on sera to confirm IgM positivity. Results: we included 180 patients (59 GBS, 51 NA, 70 Bell's palsy cases) and corresponding matched controls (blood donors) with median age 51 years for both groups and equal gender distribution. Six IgM+ cases were detected in the NA, two in the GBS, and none in the Bell's palsy group. Two controls were anti-HEV IgM-positive. At disease onset, most cases with acute HEV infection had increased liver enzymes. A moderate association (p = 0.027, Fisher's exact test; Cramér's V = −0.25) was observed only between acute HEV infection and NA. Conclusion: this prospective observational study suggests an association between concomitant acute HEV infection and NA, but not with GBS or Bell's palsy.