Volume 17, Number 2—February 2011
CME ACTIVITY
Hepatitis E Virus and Neurologic Disorders
Nassim Kamar
, 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
, Richard P. Bendall, Jean Marie Peron, Pascal Cintas, Laurent Prudhomme, Jean Michel Mansuy, Lionel Rostaing, Frances Keane, Samreen Ijaz, Jacques Izopet, and Harry R. DaltonTable 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 |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEV IgG/IgM | HEV RNA | ALT, 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.
