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DOI: 10.1055/s-2005-864787
The Nervous System and Hepatitis C Virus
Publikationsverlauf
Publikationsdatum:
25. Februar 2005 (online)
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Hepatitis C virus (HCV)-associated nervous system disorders have been described with increasing frequency in the literature, but definitive conclusions regarding their pathogenesis is for the most part lacking. Best established are complications due to cryoglobulinemia, vasculitis, and thrombosis, in which focal disturbances of peripheral nerve or brain function are seen. Rarer are cases of inflammatory encephalitis and/or myelitis similar to other flaviviral infections. A body of literature detailing cognitive abnormalities is accumulating; still unclear is whether these neuropsychologic effects are due specifically to HCV or to other processes associated with HCV infection. HCV has been localized to the central nervous system; much of its basic neurobiology remains to be described and awaits further correlation with clinical abnormalities.
KEYWORDS
HCV - nervous system - neuropsychology
REFERENCES
- 1 McGinn T, Gardenier D, McGinn L et al.. Treating chronic hepatitis C in the primary care setting. Semin Liver Dis. 2005; 25 65-71
- 2 Ferenci P, Lockwood A, Mullen K et al.. Hepatic encephalopathy-definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th world congresses of gastroenterology, Vienna, 1998. Hepatology. 2002; 35 716-721
- 3 Puca F, Antonaci F, Panella C et al.. Psychomotor dysfunctions in alcoholic and post-necrotic cirrhotic patients without overt encephalopathy. Acta Neurol Scand. 1989; 79 280-287
- 4 Weissenborn K, Ennen J, Schomerus H, Ruckert N, Hecker H. Neuropsychological characterization of hepatic encephalopathy. J Hepatol. 2001; 34 768-773
- 5 Weissenborn K, Heidenreich S, Ennen J, Ruckert N, Hecker H. Attention deficits in minimal hepatic encephalopathy. Metab Brain Dis. 2001; 16 13-19
- 6 Kono I, Ueda Y, Nakajima K, Araki K, Kagawa K, Kashima K. Subcortical impairment in subclinical hepatic encephalopathy. J Neurol Sci. 1994; 126 162-167
- 7 Edwin D, Flynn L, Klein A, Thuluvath P. Cognitive impairment in alcoholic and nonalcoholic cirrhotic patients. Hepatology. 1999; 30 1363-1367
- 8 Hilsabeck R, Perry W, Hassanein T. Neuropsychological impairment in patients with chronic hepatitis C. Hepatology. 2002; 35 440-446
- 9 Forton D, Thomas H, Murphy C et al.. Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology. 2002; 35 433-439
- 10 Ryan E, Morgello S, Isaacs K, Naseer M, Gerits P. for the Manhattan HIV Bank. Neuropsychiatric impact of hepatitis C on advanced HIV. Neurology. 2004; 62 957-962
- 11 Kramer L, Bauer E, Funk G et al.. Subclinical impairment of brain function in chronic hepatitis C infection. J Hepatol. 2002; 37 349-354
- 12 Kramer L, Bauer E, Gendo A et al.. Neurophysiological evidence of cognitive impairment in patients without hepatic encephalopathy after transjugular intrahepatic portosystemic shunts. Am J Gastroenterol. 2002; 97 162-166
- 13 Kügler C, Lotterer E, Petter J et al.. Visual event-related P300 potentials in early portosystemic encephalopathy. Gastroenterology. 1992; 103 302-310
- 14 Forton D, Allsop J, Main J, Foster G, Thomas H, Taylor-Robinson S. Evidence for a cerebral effect of the hepatitis C virus. Lancet. 2001; 358 38-39
- 15 Ross B, Jacobson S, Villamil F et al.. Subclinical hepatic encephalopathy: proton MR spectroscopic abnormalities. Radiology. 1994; 193 457-463
- 16 Taylor-Robinson S. Application of magnetic resonance spectroscopy to chronic liver disease. Clin Med. 2001; 1 54-60
- 17 Rodger A, Jolley D, Thompson S, Lanigan A, Crofts N. The impact of diagnosis of hepatitis C virus on quality of life. Hepatology. 1999; 30 1299-1301
- 18 Foster G, Goldin R, Thomas H. Chronic hepatitis C virus infection causes a significant reduction in quality of life in the absence of cirrhosis. Hepatology. 1998; 27 209-212
- 19 Bonkovsky H, Woolley J. the Consensus Interferon Study Group . Reduction of health-related quality of life in chronic hepatitis C and improvement with interferon therapy. Hepatology. 1999; 29 264-270
- 20 Dieperink E, Willenbring M, Ho S. Neuropsychiatric symptoms associated with hepatitis C and interferon alpha: a review. Am J Psychiatry. 2000; 157 867-876
- 21 Paterson D, Gayowski T, Wannstedt C et al.. Quality of life in long-term survivors after liver transplantation: impact of recurrent viral hepatitis C virus hepatitis. Clin Transplant. 2000; 14 48-54
- 22 Singh N, Gayowski T, Wagener M, Marino I. Quality of life, functional status, and depression in male liver transplant recipients with recurrent viral hepatitis C. Transplantation. 1999; 67 69-72
- 23 Heckmann J, Kayser C, Heuss D, Manger B, Blum H, Neundörfer B. Neurological manifestations of chronic hepatitis C. J Neurol. 1999; 246 486-491
- 24 Khella S, Souayah N. Hepatitis C: a review of its neurologic complications. Neurologist. 2002; 8 101-106
- 25 Tembl J, Ferrer J, Sevilla M, Lago A, Mayordomo F, Vilchez J. Neurologic complications associated with hepatitis C virus infection. Neurology. 1999; 53 861-864
- 26 Origgi L, Vanoli M, Carbone A, Grasso M, Scorza R. Central nervous system involvement in patients with HCV-related cryoglobulinemia. Am J Med Sci. 1998; 315 208-210
- 27 Malnick S, Abend Y, Evron E, Sthoeger Z. HCV hepatitis associated with anticardiolipin antibody and a cerebrovascular accident. J Clin Gastroenterol. 1997; 24 40-42
- 28 Ramos-Casals M, Cervera R, Lagrutta M et al.. Clinical features related to antiphospholipid syndrome in patients with chronic viral infections (hepatitis C virus/HIV infection): description of 82 cases. Clin Infect Dis. 2004; 38 1009-1016
- 29 Nolte C, Endres A, Meisel H. Sensory ataxia in myelopathy with chronic hepatitis C virus infection. Neurology. 2002; 59 958
- 30 Bolay H, Söylemezoglu F, Nurlu G, Tuncer S, Varli K. PCR detected hepatitis C virus genome in the brain of a case with progressive encephalomyelitis with rigidity. Clin Neurol Neurosurg. 1996; 98 305-308
- 31 Fujita H, Chuganji Y, Yaginuma M, Momoi M, Tanaka T. Acute encephalitis and hepatitis C virus infection: case report: acute encephalitis immediately prior to acute onset of hepatitis C virus infection. J Gastroenterol Hepatol. 1999; 14 1129-1131
- 32 Gazzola P, Mavilio D, Costa P et al.. Possible hepatitis C virus involvement in acute meningoradiculitis/polyradiculitis of HIV-1-co-infected patients. AIDS. 2001; 15 539-543
- 33 Sacconi S, Salviati L, Merelli E. Acute disseminated encephalomyelitis associated with hepatitis C virus infection. Arch Neurol. 2001; 58 1679-1681
- 34 Authier F, Bassez G, Payan C et al.. Detection of genomic viral RNA in nerve and muscle of patients with HCV neuropathy. Neurology. 2003; 60 808-812
- 35 Forton D, Karayiannis P, Mahmud N, Taylor-Robinson S, Thomas H. Identification of unique hepatitis C virus quasispecies in the central nervous system and comparative analysis of internal translational efficiency of brain, liver, and serum variants. J Virol. 2004; 78 5170-5183
- 36 Laskus T, Radkowski M, Bednarska A et al.. Detection and analysis of hepatitis C virus sequences in cerebrospinal fluid. J Virol. 2002; 76 10064-10068
- 37 Maggi F, Giorgi M, Fornai C et al.. Detection and quasispecies analysis of hepatitis C virus in the cerebrospinal fluid of infected patients. J Neurovirol. 1999; 5 319-323
- 38 Morsica G, Bernardi M, Novati R, Foppa C, Castagna A, Lazzarin A. Detection of hepatitis C virus genomic sequences in the cerebrospinal fluid of HIV-infected patients. J Med Virol. 1997; 53 252-254
- 39 Radkowski M, Wilkinson J, Nowicki M et al.. Search for hepatitis C virus negative-strand RNA sequences and analysis of viral sequences in the central nervous system: Evidence of replication. J Virol. 2002; 76 600-608
- 40 Vargas H, Laskus T, Radkowski M et al.. Detection of hepatitis C virus sequences in brain tissue obtained in recurrent hepatitis C after liver transplantation. Liver Transpl. 2002; 8 1014-1019
Susan MorgelloM.D.
Department of Pathology (Neuropathology), Mount Sinai Medical Center
Box 1134, 1 Gustave L Levy Place, New York, NY 10029
eMail: susan.morgello@mssm.edu