OBJECTIVE To determine the clinical phenotype of Guillain-Barré syndrome (GBS) after Zika virus (ZIKV) infection, the anti-glycolipid antibody signature, and the role of other circulating arthropod-borne viruses, we describe a cohort of GBS patients identified during ZIKV and chikungunya virus (CHIKV) outbreaks in Northeast Brazil. METHODS We prospectively recruited GBS patients from a regional neurology center in Northeast Brazil between December 2014 and February 2017. Serum and CSF were tested for ZIKV, CHIKV, and dengue virus (DENV), by RT-PCR and antibodies, and serum was tested for GBS-associated antibodies to glycolipids. RESULTS Seventy-one patients were identified. Forty-eight (68%) had laboratory evidence of a recent arbovirus infection; 25 (52%) ZIKV, 8 (17%) CHIKV, 1 (2%) DENV, and 14 (29%) ZIKV and CHIKV. Most patients with a recent arbovirus infection had motor and sensory symptoms (72%), a demyelinating electrophysiological subtype (67%) and a facial palsy (58%). Patients with a recent infection with ZIKV and CHIKV had a longer hospital admission and more frequent mechanical ventilation compared to the other patients. No specific anti-glycolipid antibody signature was identified in association with arbovirus infection, although significant antibody titres to GM1, GalC, LM1, and GalNAc-GD1a were found infrequently. CONCLUSION A large proportion of cases had laboratory evidence of a recent infection with ZIKV or CHIKV, and recent infection with both viruses was found in almost one third of patients. Most patients with a recent arbovirus infection had a sensorimotor, demyelinating GBS. We did not find a specific anti-glycolipid antibody signature in association with arbovirus-related GBS.

中文翻译：

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巴西东北部寨卡病毒爆发期间的格林-巴利综合征：一项观察性队列研究

目的 为了确定寨卡病毒 (ZIKV) 感染后格林-巴利综合征 (GBS) 的临床表型、抗糖脂抗体特征以及其他循环节肢动物传播病毒的作用，我们描述了在 ZIKV 期间发现的一组 GBS 患者和基孔肯雅病毒（CHIKV）在巴西东北部爆发。方法 我们在 2014 年 12 月至 2017 年 2 月期间从巴西东北部的一个区域神经病学中心前瞻性招募 GBS 患者。通过 RT-PCR 和抗体检测血清和脑脊液的 ZIKV、CHIKV 和登革热病毒 (DENV)，并检测血清GBS 相关的糖脂抗体。结果 确定了 71 名患者。48 人 (68%) 有近期感染虫媒病毒的实验室证据；25 (52%) ZIKV、8 (17%) CHIKV、1 (2%) DENV 和 14 (29%) ZIKV 和 CHIKV。大多数近期感染虫媒病毒的患者有运动和感觉症状（72%）、脱髓鞘电生理亚型（67%）和面瘫（58%）。与其他患者相比，近期感染 ZIKV 和 CHIKV 的患者住院时间更长，机械通气频率更高。没有发现与虫媒病毒感染相关的特异性抗糖脂抗体特征，尽管很少发现针对 GM1、GalC、LM1 和 GalNAc-GD1a 的显着抗体滴度。结论 大部分病例有近期感染 ZIKV 或 CHIKV 的实验室证据，近三分之一的患者近期感染了这两种病毒。大多数近期感染虫媒病毒的患者都有感觉运动性脱髓鞘性 GBS。