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Volume 17, Number 2—February 2011


Hepatitis E Virus and Neurologic Disorders

Nassim KamarComments to Author , Richard P. Bendall, Jean Marie Peron, Pascal Cintas, Laurent Prudhomme, Jean Michel Mansuy, Lionel Rostaing, Frances Keane, Samreen Ijaz, Jacques Izopet, and Harry R. Dalton
Author affiliations: Author affiliations: Centre Hospitalier Universitaire Rangueil, Toulouse, France (N. Kamar, P. Cintas, L. Rostaing); Université Paul Sabatier, Toulouse (N. Kamar, J.M. Peron, L. Rostaing, J. Izopet); Royal Cornwall Hospital Trust, Truro, UK (R.P. Bendall, F. Keane, H.R. Dalton); Centre Hospitalier Universitaire Purpan, Toulouse (J.M. Peron, J.M. Mansuy, J. Izopet); Centre Hospitalier de Castres, Castres, France (L. Prudhomme); Health Protection Agency, London, UK (S. Ijaz); Peninsula College of Medicine and Dentistry, Truro (H.R. Dalton)

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Table 1

Summary of 7 cases of HEV–associated neurologic disorders, Cornwall, UK, and Toulouse, France*

Patient no. Relevant medical status HEV infection phase† HEV genotype Serum
Cerebrospinal fluid
IU/L† Bilirubin, µmol/L HEV RNA Protein level, g/L Leukocytes, cells/mm3
1 Not immunocompromised Acute 3e +/+ + 623 14 1.27 145
2 Not immunocompromised Acute 3e +/+ + 1160 70 ND
3 Not immunocompromised Acute 3f +/+ + 384 35 2 14
4 Kidney–pancreas transplant recipient Chronic 3f +/+ + 173 19 + 0.71 1
5 Kidney transplant recipient Chronic 3f –/+ + 110 12 + 0.8 8
6 Kidney transplant recipient Chronic 3f +/+ + 105 12 + 0.76 7
7‡ HIV positive Chronic 3a +/+ + 150 9 + 0.47 1

*HEV, hepatitis E virus; Ig, immunoglobulin; ALT, alanine aminotransferase; +, positive; –, negative; ND, not done.
†At time of examination for neurologic symptoms.
‡This patient had positive IgG and IgM Wantai assay results throughout but had negative HEV IgG and IgM results for 3 separate Genelabs assays during 2007–2008.

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