Long-Term Neurological Manifestations in HEV-Infected Immigrant Patients: A 11-year Follow-up Study on Meningo-Encephalomyelitis.

This letter reports long-term (6-11 years) follow-up of a series with acute Hepatitis E virus (HEV) infection, highlighting its neurotropic potential in immunocompetent individuals. Among 20 individuals with documented viremia, 15% developed delayed meningo-encephalomyelitis, despite no acute neurological signs. HEV RNA detection in cerebrospinal fluid supports the role of active viral replication in central nervous system invasion. Both genotype 3 and genotype 1 were implicated. Two patients later developed neoplastic diseases in lung and pancreas. Although limited by small sample size, findings suggest neurological complications of HEV may be underrecognized and warrant broader diagnostic screening beyond acute hepatitis.