Neurologic complications of hepatitis C

Jayant Acharya, Vitor H. Pacheco

Research output: Contribution to journalReview article

39 Citations (Scopus)

Abstract

BACKGROUND: Hepatitis C virus (HCV) infection is a common and chronic disorder with numerous extrahepatic manifestations. We review the neurologic complications in this article. REVIEW SUMMARY: Neurologic complications can involve the peripheral or the central nervous system. The most frequently reported complication is a subacute, distal, symmetric, sensorimotor polyneuropathy in the presence of mixed cryoglobulinemia (MC). HCV infection is the most common cause of MC. In HCV-infected patients without MC, mononeuropathy or mononeuropathy multiplex is more common. Both ischemic and hemorrhagic strokes, probably related to MC and vasculitis, have been described. More recently, transverse myelopathy and cognitive impairment have been linked to HCV infection, but the association is less certain and needs to be confirmed in larger studies. HCV has also been reported as a possible cause of encephalomyelitis in some cases. Although there are no definite treatment guidelines, immunomodulating agents and antiviral therapy are most often used with favorable outcomes. CONCLUSIONS: HCV infection should be considered in the differential diagnosis of a variety of neurologic disorders. Further studies are necessary to establish the full spectrum of the neurologic complications, identify specific pathophysiologic mechanisms, and provide clear guidelines for management.

Original languageEnglish (US)
Pages (from-to)151-156
Number of pages6
JournalNeurologist
Volume14
Issue number3
DOIs
StatePublished - May 1 2008

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Hepatitis C
Hepacivirus
Nervous System
Cryoglobulinemia
Virus Diseases
Mononeuropathies
Guidelines
Encephalomyelitis
Polyneuropathies
Spinal Cord Diseases
Vasculitis
Nervous System Diseases
Antiviral Agents
Differential Diagnosis
Central Nervous System
Stroke
Therapeutics

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Acharya, Jayant ; Pacheco, Vitor H. / Neurologic complications of hepatitis C. In: Neurologist. 2008 ; Vol. 14, No. 3. pp. 151-156.
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Neurologic complications of hepatitis C. / Acharya, Jayant; Pacheco, Vitor H.

In: Neurologist, Vol. 14, No. 3, 01.05.2008, p. 151-156.

Research output: Contribution to journalReview article

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AB - BACKGROUND: Hepatitis C virus (HCV) infection is a common and chronic disorder with numerous extrahepatic manifestations. We review the neurologic complications in this article. REVIEW SUMMARY: Neurologic complications can involve the peripheral or the central nervous system. The most frequently reported complication is a subacute, distal, symmetric, sensorimotor polyneuropathy in the presence of mixed cryoglobulinemia (MC). HCV infection is the most common cause of MC. In HCV-infected patients without MC, mononeuropathy or mononeuropathy multiplex is more common. Both ischemic and hemorrhagic strokes, probably related to MC and vasculitis, have been described. More recently, transverse myelopathy and cognitive impairment have been linked to HCV infection, but the association is less certain and needs to be confirmed in larger studies. HCV has also been reported as a possible cause of encephalomyelitis in some cases. Although there are no definite treatment guidelines, immunomodulating agents and antiviral therapy are most often used with favorable outcomes. CONCLUSIONS: HCV infection should be considered in the differential diagnosis of a variety of neurologic disorders. Further studies are necessary to establish the full spectrum of the neurologic complications, identify specific pathophysiologic mechanisms, and provide clear guidelines for management.

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