Serological indication of chronic inflammatory demyelinating polyneuropathy as an extrahepatic manifestation of hepatitis E virus infection

• Published in: Scientific reports Vol. 14; no. 1; pp. 19244 - 8
• Main Authors: Pischke, S., Kjasimov, A., Skripuletz, T., Casar, C., Bannasch, J., Mader, M., Huber, S., Konen, F., Wolski, A., Horvatits, T., Gingele, S., Peine, S., Hiller, J., Seeliger, T., Thayssen, G., Lütgehetmann, M., Schulze zur Wiesch, J., Golsari, A., Gelderblom, M.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 20.08.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4020; 692/617; Adult; Aged; Anti-HEV-IgG; Blood; Blood donors; Cerebrospinal fluid; Chronic infection; CIDP; Demyelination; Diagnosis; Female; Genotype & phenotype; Genotypes; Guillain-Barre syndrome; Hepatitis; Hepatitis Antibodies - blood; Hepatitis E; Hepatitis E - blood; Hepatitis E - complications; Hepatitis E - immunology; Hepatitis E virus - immunology; HEV; Humanities and Social Sciences; Humans; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin M; Immunoglobulin M - blood; Immunoglobulins; Infections; Inflammation; Intravenous administration; Male; Middle Aged; multidisciplinary; Myasthenia gravis; Neuromuscular junctions; Peripheral neuropathy; Polyneuropathy; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - blood; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - immunology; Science; Science (multidisciplinary); Serology; Viremia; HEV; Hepatitis E; Myasthenia gravis; CIDP; Anti-HEV-IgG
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-70104-3

Guillain–Barré syndrome and neuralgic amyotrophy have been associated with hepatitis E virus (HEV) genotype 3 infections, while myasthenia gravis (MG) has been associated with HEV genotype 4 infections. However, whether chronic inflammatory demyelinating polyneuropathy (CIDP) is associated with HEV infections has not been conclusively clarified yet. 102 CIDP patients, 102 age- and sex-matched blood donors, 61 peripheral neuropathy patients (non-CIDP patients), and 26 MG patients were tested for HEV and anti-HEV IgM and IgG. Sixty-five of the 102 (64%) CIDP patients tested positive for anti-HEV IgG and one (1%) for anti-HEV IgM. No other patient tested positive for ati-HEV IgM. In the subgroup of CIDP patients with initial diagnosis (without previous IVIG treatment), 30/54 (56%) tested positive for anti-HEV IgG. Anti-HEV rates were significantly lower in blood donors (28%), non-CIDP peripheral neuropathy patients (20%), and MG patients (12%). No subject tested positive for HEV viremia. CSF tested negative for in 61 CIDP patients (54 patients with primary diagnosis). The development of CIDP but not non-CIDP polyneuropathy may be triggered by HEV exposure in an HEV genotype 3 endemic region. The increased anti-HEV seroprevalence in CIDP patients is not a consequence of IVIG therapy.