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Review of Hepatitis E Virus Associated Neurological Injury Syndromes

Review of Hepatitis E Virus Associated Neurological Injury Syndromes
Photo by National Institute of Allergy and Infectious Diseases / Unsplash
Key Takeaway
Note that HEV-associated neurological injury is described, though specific outcome data and sample sizes are unreported.

This publication is classified as a review focusing on neurological manifestations linked to Hepatitis E virus (HEV) infection. The scope encompasses several distinct neurological conditions identified in the source material, including Hepatitis E virus-associated neurological injury, Guillain–Barré syndrome, neuralgic amyotrophy, encephalitis, and myelitis. The authors aim to synthesize available information regarding these associations rather than presenting new primary trial data.

The source does not report specific main results, primary outcomes, or secondary outcomes. Consequently, no pooled effect sizes, confidence intervals, or p-values are available for synthesis. The population, sample size, setting, and follow-up duration are also not reported within the provided documentation. Without these quantitative details, the magnitude of the association remains undefined in this summary.

Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, are not reported. The authors do not explicitly list limitations or funding sources in the provided metadata. The certainty of the evidence and causality notes are also not reported, preventing a definitive assessment of the strength of the link between HEV and the listed neurological conditions.

Practice relevance is not reported, limiting the ability to derive specific clinical recommendations from this review alone. Clinicians should recognize that while the conditions are listed, the evidence base described lacks the numerical grounding necessary for robust decision-making. Further primary research or systematic reviews with reported data would be required to establish clear management guidelines.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
Hepatitis E virus (HEV) is increasingly recognized as a cause of neurological disease beyond its hepatic manifestations. Neurological complications are the most frequently reported extrahepatic presentations and include both peripheral nervous system disorders, such as Guillain–Barré syndrome (GBS) and neuralgic amyotrophy (NA), and central nervous system (CNS) involvement, including encephalitis and myelitis, often in the absence of overt hepatitis. This review summarizes the clinical spectrum of HEV-associated neurological disease and integrates evidence from human studies and experimental models. Current evidence supports multifactorial pathogenesis, with direct viral neuroinvasion of the CNS and immune-mediated mechanisms predominating in peripheral neuropathies. Experimental in vivo and in vitro systems demonstrate that HEV can cross the blood–brain barrier (BBB) and replicate within neural tissues, providing biological plausibility for CNS involvement. By synthesizing clinical and experimental findings, this review highlights the dual pathogenic pathways underlying HEV-associated neurological injury and outlines key unresolved questions relevant to diagnosis, pathogenesis, and clinical management.
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