Hepatitis E is hyperendemic in many developing countries in Asia and Africa, and is caused by hepatitis E virus (HEV) genotypes 1 and 2, which are spread via the faecal-oral route by contaminated water. Recent data show that HEV infection is also endemic in developed countries. In such geographical settings, hepatitis E is caused by HEV genotypes 3 and 4, and is mainly a porcine zoonosis. In a minority of cases, HEV causes acute and chronic hepatitis, but infection is commonly asymptomatic or unrecognized. HEV infection is associated with a number of extrahepatic manifestations, including a range of neurological injuries. To date, 91 cases of HEV-associated neurological injury-most commonly, Guillain-Barré syndrome, neuralgic amyotrophy, and encephalitis/myelitis-have been reported. Here, we review the reported cases, discuss possible pathogenic mechanisms, and present our perspectives on future directions and research questions.

doi.org/10.1038/nrneurol.2015.234, hdl.handle.net/1765/86126
Nature Reviews Neurology
Department of Neurology

Dalton, H.R, Kamar, N, van Eijk, J.J.J, Mclean, B.N, Cintas, P, Bendall, R.P, & Jacobs, B.C. (2015). Hepatitis E virus and neurological injury. Nature Reviews Neurology (Vol. 12, pp. 77–85). doi:10.1038/nrneurol.2015.234