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Hepatitis E virus and neurological disorders
  1. Brendan N Mclean1,
  2. James Gulliver2,
  3. Harry R Dalton2,3
  1. 1Neurology Department, The Royal Cornwall Hospitals NHS Trust, Truro, UK
  2. 2Gastroenterology Department, The Royal Cornwall Hospitals NHS Trust, Truro, UK
  3. 3European Centre for Environment and Human Health, University of Exeter, Truro, UK
  1. Correspondence to Dr Brendan N Mclean, Neurology Department, The Royal Cornwall Hospitals NHS Trust, Truro, TR1 3LJ, UK; brendan.mclean{at}


Hepatitis E is the most common cause of hepatitis worldwide. While originally considered a disease of developing countries, it is increasingly recognised in developed countries, probably related to contaminated pork meat, and where infection is often asymptomatic. However, several non-liver manifestations have become apparent, the most important of which are neurological, including Guillain-Barré syndrome (acute inflammatory demyelinating polyradiculoneuropathy (AIDP)), neuralgic amyotrophy and meningoencephalitis. We recommend testing all patients with AIDP and neuralgic amyotrophy for hepatitis E and consider testing any patient with an unexplained neurological illness and abnormal liver function tests for the virus.

  • Hepatitis E
  • Guillain-Barre Syndrome
  • Neuralgic Amyotropthy
  • Meningoencephalitis

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  • Contributors BNM wrote the first draft, HRD amended and provided the figures and tables and JG referenced and further amended the paper.

  • Competing interests HRD has received travel and accommodation costs and consultancy fees from GSK, Wantai and Roche; travel accommodation and lecture fees from Merck, Gilead, GFE Blut BmBh; travel and accommodation costs from the Gates Foundation and Medicins Sans Frontieres. BNM has received honoraria, lecture fees and conference fees from Eisai, GSK, Sanofi, Novartis and Biogen. RG has no competing interests to declare.

  • Patient consent It is a review article and not relevant.

  • Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Nick Davies, London, UK.

  • Data sharing statement All data used has been referenced in this paper.

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