Aude Belbézier1, Alban Deroux2, Françoise Sarrot-Reynauld2, Barbara Colombe2, Annick Bosseray2, Claire Wintenberger2, Perrine Dumanoir2, Maxime Lugosi2, Isabelle Boccon-Gibod2, Vincent Leroy3, Maxime Maignan4, Roselyne Collomb-Muret4, Damien Viglino4, Mathieu Vaillant5, Lorella Minotti5, Emeline Lagrange5, Olivier Epaulard6, Chantal Dumestre-Perard7, Sébastien Lhomme8, Julien Lupo9, Sylvie Larrat9, Patrice Morand9, Carole Schwebel10, Antoine Vilotitch11, Jean-Luc Bosson12, Laurence Bouillet13. 1. Department of Internal Medicine, Grenoble University Hospital, Grenoble, France. Electronic address: abelbezier1@chu-grenoble.fr. 2. Department of Internal Medicine, Grenoble University Hospital, Grenoble, France. 3. Department of Hepatology, Grenoble University Hospital, Grenoble, France. 4. Department of Emergency, Grenoble University Hospital, Grenoble, France. 5. Department of Neurology, Grenoble University Hospital, Grenoble, France. 6. Univ. Grenoble Alpes, Department of Infectious Disease, Grenoble University Hospital, Grenoble, France. 7. Univ. Grenoble Alpes, CNRS, Laboratory of Immunology CHU Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France. 8. INSERM, U1043, Centre de Physiopathologie de Toulouse Purpan, Toulouse, F-31300, France; CHU Toulouse, Hôpital Purpan, Laboratoire de virologie, F-31300, France. 9. Univ. Grenoble Alpes, CEA, CNRS, Virology Laboratory CHU Grenoble Alpes, IBS, 38000 Grenoble, France. 10. Univ. Grenoble Alpes, Laboratory of Bioclinical Pharmaceutic CHU Grenoble Alpes, INSERM U1039, 38000 Grenoble, France. 11. Department of Public Health, Grenoble University Hospital, Grenoble, France. 12. Department of Public Health, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, CNRS, Public Health Department CHU Grenoble Alpes, TIMC-IMAG, 38000 Grenoble, France. 13. Department of Internal Medicine, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, Department of Internal Medicine CHU Grenoble, Inserm (U1036), CEA, BIG-BCI, France.
Abstract
INTRODUCTION: Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury. METHOD: A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data on patients with acute (<3 months) non-traumatic, non-metabolic, non-vascular neurological injuries. Acute hepatitis E was defined as anti-HEV IgM-positive serum in immunocompetent patient, and as anti-HEV IgM-positive serum or HEV RNA-positive serum in immunocompromised patients. RESULTS: One hundred fifty-nine patients were included. Anti-HEV IgM seroprevalence in our cohort of non-traumatic, non-metabolic, non-vascular neurological injuries was 6.9% (eleven patients, including 4 Parsonage-Turner syndrome (PTS) and 2 Guillain-Barré syndrome (GBS)). Elevated transaminases were observed in only 64% of hepatitis E patients and cholestasis in 64%. CONCLUSION: In this study, 6·9% of patients with acute non-traumatic, non-metabolic, non-vascular neurological injuries had a probable recent HEV infection. HEV serology should be systematically performed in this population, even in patients with normal transaminase level.
INTRODUCTION:Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury. METHOD: A registry was created in Grenoble Hospital University from 2014 to 2018 to collect data on patients with acute (<3 months) non-traumatic, non-metabolic, non-vascular neurological injuries. Acute hepatitis E was defined as anti-HEV IgM-positive serum in immunocompetent patient, and as anti-HEV IgM-positive serum or HEV RNA-positive serum in immunocompromised patients. RESULTS: One hundred fifty-nine patients were included. Anti-HEV IgM seroprevalence in our cohort of non-traumatic, non-metabolic, non-vascular neurological injuries was 6.9% (eleven patients, including 4 Parsonage-Turner syndrome (PTS) and 2 Guillain-Barré syndrome (GBS)). Elevated transaminases were observed in only 64% of hepatitis Epatients and cholestasis in 64%. CONCLUSION: In this study, 6·9% of patients with acute non-traumatic, non-metabolic, non-vascular neurological injuries had a probable recent HEV infection. HEV serology should be systematically performed in this population, even in patients with normal transaminase level.