Extrahepatic manifestations of hepatitis E virus: An overview

Clin Mol Hepatol. 2020 Jan;26(1):16-23. doi: 10.3350/cmh.2019.0082. Epub 2019 Oct 11.

Abstract

Hepatitis E virus (HEV) is a significant health problem with approximately 20 million individuals infected annually. HEV infection has been associated with a wide spectrum of extrahepatic manifestations, including neurological, hematological and renal disorders. Guillain-Barré syndrome and neuralgic amyotrophy are the most frequent neurological manifestations. In addition, HEV infection has been observed with other neurological diseases, such as encephalitis, myelitis and Bell's palsy. Hematologic manifestations include anemia due to glucose-6-phospate dehydrogonase deficiency, autoimmune hemolytic anemia and severe thrombocytopenia. Membranoproliferative glomerulonephritis and relapse IgA nephropathy with or without coexisting cryoglobulinemia appear to be the most common renal injuries related with HEV infection. Also, HEV infection has been associated with acute pancreatitis and other immune-mediated manifestations, such as arthritis and myocarditis. However, the pathophysiologic mechanisms of HEV-related extrahepatic manifestations are still largely unclear.

Keywords: Hematologic diseases; Hepatitis E; Kidney; Neurologic manifestations.

Publication types

  • Review

MeSH terms

  • Glucosephosphate Dehydrogenase / genetics
  • Glucosephosphate Dehydrogenase / metabolism
  • Guillain-Barre Syndrome / etiology
  • Guillain-Barre Syndrome / pathology
  • Hematologic Diseases / etiology
  • Hematologic Diseases / pathology
  • Hepatitis E / complications
  • Hepatitis E / metabolism
  • Hepatitis E / pathology*
  • Hepatitis E virus / physiology*
  • Humans
  • Kidney Diseases / etiology
  • Kidney Diseases / pathology
  • Nervous System Diseases / etiology
  • Nervous System Diseases / pathology
  • Pancreatitis / etiology
  • Pancreatitis / pathology

Substances

  • Glucosephosphate Dehydrogenase