Human Parechoviruses, New Players in the Pathogenesis of Viral Meningitis

Human parechoviruses (HPeVs) belong to the family of Picornaviridae and have been recognized as a separate group on the basis of distinct molecular and biological properties since 1999. The identification of HPeV3 in 2004 and its association with neonatal sepsis and meningitis made it particularly clear that HPeVs are related to severe disease in infants. Molecular techniques are increasingly being used for the identification of HPeVs and with the increase in epidemiological and clinical data, HPeVs are now considered to be the second predominant cause of viral meningitis, following enteroviruses (EVs). This review focuses on the role of HPeVs, with particular notice to HPeV3, as a causative agent in viral meningitis as well as neonatal sepsis and encephalitis. Data on epidemiology, clinical manifestations, immunology and molecular and cellular biology, underlying the greater pathogenicity of this novel group of viruses as well as the diagnosis, management and treatment options will be discussed.