Ghasemi Amirhosein, Broomand Lomer Nima, Saberi Alia
Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Neurosciences Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
eNeurologicalSci. 2025 Jan 6;38:100551. doi: 10.1016/j.ensci.2025.100551. eCollection 2025 Mar.
Guillain-Barré syndrome (GBS) is an inflammatory disorder of the peripheral nervous system, causing acute flaccid paralysis. There have been occasional reports linking Hepatitis A virus (HAV) to GBS. Here we aimed to evaluate the current literature on the association between GBS and HAV, exploring potential mechanisms and clinical implications.
We conducted a systematic search using PRISMA guidelines in PubMed, Web of Science, Embase, and Scopus. Only published case reports or conference abstracts presenting cases of confirmed HAV infection and GBS were included. Data extraction was performed independently by two reviewers, and quality assessment was conducted using the Joanna Briggs Institute critical appraisal tool.
Out of 581 studies identified, 46 studies encompassing 47 cases met the inclusion criteria. The mean age of patients was 29.47 years, with a male predominance (70.2 %). Geographically, most cases were reported in Asia (74.5 %). Clinical manifestations of HAV included fever, malaise, and jaundice, while GBS presented with muscle weakness and areflexia. Laboratory findings showed albuminocytological dissociation in 76.2 % of cases. Nerve conduction studies predominantly indicated AIDP subtype (32/46, 69.6 %). Treatment involved IVIG, plasmapheresis, and supportive care, with recovery times ranging from one week to 18 months. One fatality was reported.
This review suggests a potential link between HAV infection and GBS, proposing a mechanism: molecular mimicry. It emphasizes the need for increased awareness and preventive measures, especially in areas with lower health standards. However, further research is needed to clarify the possible mechanisms and deepen our understanding.
吉兰-巴雷综合征（GBS）是一种周围神经系统的炎症性疾病，可导致急性弛缓性麻痹。偶尔有报告将甲型肝炎病毒（HAV）与GBS联系起来。在此，我们旨在评估当前关于GBS与HAV关联的文献，探讨潜在机制和临床意义。
我们按照PRISMA指南在PubMed、科学网、Embase和Scopus中进行了系统检索。仅纳入发表的病例报告或会议摘要，这些报告或摘要呈现了确诊的HAV感染和GBS病例。由两名审阅者独立进行数据提取，并使用乔安娜·布里格斯研究所的批判性评估工具进行质量评估。
在检索到的581项研究中，46项研究（涵盖47例病例）符合纳入标准。患者的平均年龄为29.47岁，男性占主导（70.2%）。在地理分布上，大多数病例报告来自亚洲（74.5%）。HAV的临床表现包括发热、不适和黄疸，而GBS表现为肌肉无力和腱反射消失。实验室检查结果显示76.2%的病例存在蛋白细胞分离。神经传导研究主要表明为急性炎症性脱髓鞘性多发性神经病（AIDP）亚型（32/46，69.6%）。治疗包括静脉注射免疫球蛋白、血浆置换和支持性护理，恢复时间从一周到18个月不等。报告了1例死亡病例。
本综述表明HAV感染与GBS之间可能存在联系，提出了一种机制：分子模拟。它强调需要提高认识并采取预防措施，特别是在卫生标准较低的地区。然而，需要进一步研究以阐明可能的机制并加深我们的理解。
