Systematic review of factors associated with the development of Guillain–Barré syndrome 2007–2017: what has changed?

Abstract

Objective 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. Method 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. Results 34 articles met inclusion criteria and were selected for analysis. Their quality was considered good in relation to most of the items evaluated. Many etiological agents had 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 etiological 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 etiological 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. Conclusions The results of the review reaffirmed Campylobacter 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.