The potential role of hepatitis C virus in the pathogenesis of the neurological syndrome in chronic hepatitis C

Caudai, Cinzia; Maimone, Davide; Almi, P; Annunziata, Pasquale; Bastianoni, I; Boggiano, César; Guazzi, G. C.; Padula, M. G.; Valensin, Pier Egisto

doi:10.1136/gut.41.3.411

Cited by 25 publications

(11 citation statements)

References 9 publications

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“…HCV belongs to the Flaviviridae family, which includes several neurotropic viruses [13,14]. There has been recent interest in the possibility of a link between chronic HCV infection and cognitive impairment independent of liver failure, because HCV sequences have been detected in cerebrospinal fluid (CSF) [15,16] and brain tissue [17,18] and because proton magnetic resonance spectroscopy has shown significant metabolite alterations [19,20].…”

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confidence: 99%

Pathogenesis of Hepatitis C Virus Coinfection in the Brains of Patients Infected with HIV

Letendre¹,

et al. 2007

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Involvement of the nervous system by human immunodeficiency virus (HIVNervous system involvement of HIV continues to be a serious problem, despite the development of more-potent combination antiretroviral therapy [1][2][3]. This may be related to the use of poorly penetrating antiretroviral therapy [4,5], the emergence of resistant HIV species [6,7], and an increase in the use of drugs such as methamphetamine [8]. Drug users, one of the faster growing populations with HIV, often have comorbid conditions leading to neurological complications [9,10].

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confidence: 99%

Pathogenesis of Hepatitis C Virus Coinfection in the Brains of Patients Infected with HIV

Letendre¹,

et al. 2007

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“…HCV belongs to the Flaviviridae family, which includes several well-known neurotropic viruses (e.g., yellow fever, dengue, and tick-borne encephalitis viruses), and several reports have implicated HCV as an occasional cause of various CNS and peripheral nervous system pathologies (3,6,11,13,27). Moreover, HCV RNA has been detected in cerebrospinal fluid from both HIV-positive and HIV-negative patients (23,25), and viral sequences have been amplified directly from brain tissue from a patient diagnosed with progressive encephalomyelitis (3).…”

mentioning

confidence: 99%

Search for Hepatitis C Virus Negative-Strand RNA Sequences and Analysis of Viral Sequences in the Central Nervous System: Evidence of Replication

Radkowski

Wilkinson

Nowicki

et al. 2002

J Virol

259

209

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Patients with chronic hepatitis C are more likely to have significant changes in their physical and mental well-being than patients with liver disease of other etiology, and hepatitis C virus (HCV) has been occasionally implicated in diseases of the central nervous system. We analyzed the presence of the HCV negative-strand RNA sequence, which is the viral replicative intermediary, in autopsy brain tissue samples from six HCVinfected patients. Negative-strand HCV RNA was searched for by a strand-specific Tth-based reverse transcriptase PCR, and viral sequences amplified from brain tissue and serum were compared by single-strand conformational polymorphism analysis and direct sequencing. HCV RNA negative strands were detected in brain tissue in three patients. In two of these patients, serum-and brain-derived viral sequences were different and classified as belonging to different genotypes. In one of the latter patients, HCV RNA negative strands were detected in lymph node and, while being different from serum-derived sequences, were identical to those present in the brain. The results of the present study suggest that HCV can replicate in the central nervous system, probably in cells of the macrophage/monocyte lineage.

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“…Vasculitis results from the deposition of circulating cryoglobulins and immunoglobulin M complexes containing HCV particles in vessels wall . While cryoglobulinemia‐associated vasculitis has been extensively studied in the skin, the kidney and the peripheral nervous system , little is known about the potential consequences of cryoglobulinemia on liver microcirculation and portal flow. One study has shown that among HCV‐infected patients, there was a significant increase in sinusoidal T‐cell lymphocytes in those positive for cryoglobulinemia compared to those negative for cryoglobulinemia which could result from ongoing antigenic stimulation .…”

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confidence: 99%

Interactions between virus-related factors and post-transplant ascites in patients with hepatitis C and no cirrhosis: role of cryoglobulinemia

et al. 2014

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SummaryRefractory ascites may appear in liver transplant recipients with recurrence of hepatitis C virus infection, even in the absence of advanced fibrosis. The mechanisms are unclear. The aim was to determine whether post-transplant cryoglobulinemia could be a predisposing factor for ascites in this population. Retrospective data of 82 liver transplant recipients with HCV recurrence surviving more than 1 year were collected. Cryoglobulinemia was systematically tested after transplantation. All patients had 1-year protocol biopsy with assessment of sinusoidal distension, perisinusoidal fibrosis, and centrolobular necrosis. Additional biopsies were performed when needed. Fourteen of 82 patients (17%) developed refractory ascites. When ascites appeared, fibrosis was stage F0-F1 in 36% and F2-F3 in 57%. Factors independently associated with post-transplant ascites were pretransplant refractory ascites (P = 0.001), fibrosis ≥stage 2 at 1 year (P = 0.002), perisinusoidal fibrosis at 1 year (P = 0.02), and positive cryoglobulinemia (P = 0.02). Patients with ascites had a significantly worse prognosis compared to those without ascites. Refractory ascites may occur in liver transplant recipients with HCV recurrence in the absence of advanced fibrosis. The finding that both positive cryoglobulinemia and perisinusoidal fibrosis at 1 year were significantly associated with ascites suggests that liver microangiopathy is involved in the mechanisms of HCV-related ascites.

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The potential role of hepatitis C virus in the pathogenesis of the neurological syndrome in chronic hepatitis C

Cited by 25 publications

References 9 publications

Pathogenesis of Hepatitis C Virus Coinfection in the Brains of Patients Infected with HIV

Pathogenesis of Hepatitis C Virus Coinfection in the Brains of Patients Infected with HIV

Search for Hepatitis C Virus Negative-Strand RNA Sequences and Analysis of Viral Sequences in the Central Nervous System: Evidence of Replication

Interactions between virus-related factors and post-transplant ascites in patients with hepatitis C and no cirrhosis: role of cryoglobulinemia

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