Review Article

Hepatitis E—A Concise Review of Virology, Epidemiology, Clinical Presentation and Therapy

M. C. Donnelly; L. Scobie; C. L. Crossan; H. Dalton; P. C. Hayes; K. J. Simpson


Aliment Pharmacol Ther. 2017;46(2):126-141. 

In This Article

Extrahepatic Manifestations of HEV

HEV infection may also present with extrahepatic manifestations. In vitro data have identified that HEV can replicate in non-liver cells including human intestine.[112]

Neurological manifestations have been reported in HEV genotypes 1 and 3 infection. HEV RNA has been found in the cerebrospinal fluid of patients with neurological symptoms during HEV infection.[113] A Dutch study reported up to 5% of patients with Guillain-Barre syndrome had associated acute HEV infection.[114] Other reported neurological disorders include neuralgic amyotrophy, transverse myelitis and cranial nerve palsies. Other recognised extrahepatic manifestations of HEV infection include renal impairment with cryoglobulinaemia, pancreatitis and haematological abnormalities. HEV infection can cause severe kidney disease and should be considered in cases of unexplained glomerular disease. Arthritis and pancreatitis have also been reported.