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Does acute hepatitis C infection affect the central nervous system in HIV‐1 infected individuals?
Author(s) -
Winston A.,
Garvey L.,
Scotney E.,
Yerrakalva D.,
Allsop J. M.,
Thomson E. C.,
Grover V. P. B.,
Main J.,
Cox J. I.,
Wylezinska M.,
TaylorRobinson S. D.
Publication year - 2010
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2009.01198.x
Subject(s) - medicine , hepatitis c virus , neurocognitive , gastroenterology , immunology , central nervous system , virus , cognition , psychiatry
Summary. Central nervous system (CNS) manifestations of chronic hepatitis C virus (HCV) and chronic human immune deficiency virus‐1 (HIV‐1) infections have been reported, but the impact of acute HCV infection on the CNS is unknown. A total of 10 individuals with chronic stable HIV‐1 with documented acute HCV (HCV‐RNA polymerase chain reaction positive and HCV antibody negative, group 1) underwent cerebral proton magnetic resonance spectroscopy (MRS) using acquisition parameters to quantify myo‐inositol/creatine (mI/Cr) ratio in the right basal ganglia (RBG). Two matched control groups also underwent MRS; group 2: ten with chronic HIV‐1 and no evidence of HCV, and group 3: ten with no evidence of HIV or HCV. Subjects also underwent computerized neurocognitive assessments (CogState™). RBG mI/Cr ratio in group 1 (acute HCV in a background of HIV) was significantly lower than that in groups 2 and 3 [2.90 (±0.7) vs 3.34 (±0.4) and 3.43 (±0.4), mean (SD) for group 1 vs 2 and 3 respectively, P = 0.049], with 50% of subjects in group 1 having a mI/Cr ratio below the lowest observed ratio in either of the other groups. On neurocognitive testing, significant defects in the monitoring domain were observed in group‐1, compared with matched controls ( P = 0.021). Acute HCV in HIV‐1 infected subjects is associated with CNS involvement. Clinicians should be vigilant of early CNS involvement when assessing subjects with acute HCV.