Centre for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil.
National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, Brazil.
Trop Med Int Health. 2019 Feb;24(2):132-142. doi: 10.1111/tmi.13181. Epub 2018 Dec 18.
The objective of this study was to describe the factors associated with the development of Guillain-Barré syndrome, both infectious and non-infectious, during and after the A(H1N1) influenza pandemic in 2009 and the recent Zika virus epidemic in the Americas.
Systematic review of literature on factors associated with the development of the Guillain-Barré syndrome published between 2007 and 2017 listed in EBSCO, MEDLINE and LILACS databases. The quality of the studies was evaluated using the Newcastle Ottawa Scale.
Thirty-four articles met inclusion criteria and were selected for analysis. Their quality was considered good in relation to most of the items evaluated. Many aetiological agents had the results of association with Guillain-Barré syndrome, among them Campylobacter jejuni, influenza vaccine - both pandemic and seasonal vaccines, respiratory infection, gastrointestinal infection among others. The aetiological agents found are, in most part, the same reported prior to the study period. The association with surgeries, chikungunya virus (CHIKV), Zika virus and quadrivalent human papillomavirus vaccine stand out as new aetiological agents in the list of the various possible agents that trigger Guillain-Barré syndrome reported in the study period. There were no Brazilian studies identified during this period.
The results of the review reaffirmed C. jejuni as the major trigger of GBS, whereas the association of influenza vaccines and GBS is less clear; Zika virus infection in association with GBS was found in only one study.
本研究旨在描述与 2009 年 A(H1N1)流感大流行期间和之后以及美洲最近的寨卡病毒流行期间发生的感染性和非感染性格林-巴利综合征相关的因素。
对 EBSCO、MEDLINE 和 LILACS 数据库中 2007 年至 2017 年期间发表的与格林-巴利综合征发展相关的因素进行文献系统回顾。使用纽卡斯尔-渥太华量表评估研究质量。
符合纳入标准并被选中进行分析的有 34 篇文章。与评估的大多数项目相比，其质量被认为是良好的。许多病原体与格林-巴利综合征有关，其中包括空肠弯曲菌、流感疫苗（包括大流行和季节性疫苗）、呼吸道感染、胃肠道感染等。研究期间发现的病原体与研究前报告的病原体基本相同。与手术、基孔肯雅热病毒（CHIKV）、寨卡病毒和四价人乳头瘤病毒疫苗的关联是该研究期间报告的各种可能触发格林-巴利综合征的病原体的新病原体。在此期间没有发现巴西的研究。
综述结果再次证实空肠弯曲菌是 GBS 的主要触发因素，而流感疫苗与 GBS 的关联则不太明确；仅在一项研究中发现寨卡病毒感染与 GBS 有关。
