Neurologic Manifestations of Hepatitis C Virus Infection

• Published in: Clinics in liver disease Vol. 21; no. 3; pp. 535 - 542
• Main Authors: Iriana, Sentia, MD, Curry, Michael P., MD, Afdhal, Nezam H., MD, DSc
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2017
• Subjects: Antiviral Agents - therapeutic use; Cerebrovascular disease; Cerebrovascular Disorders - virology; Electroencephalography; Fatigue; Gastroenterology and Hepatology; Hepatitis C; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Humans; Interferon; Interferons - therapeutic use; Ledipasvir/sofosbuvir; Magnetic Resonance Imaging; Mental Disorders - complications; MR spectroscopy; Neurocognition; Neurocognitive Disorders - diagnostic imaging; Neurocognitive Disorders - metabolism; Neurocognitive Disorders - physiopathology; Neurocognitive Disorders - virology; Ribavirin - therapeutic use; Fatigue; Interferon; Hepatitis C; Neurocognition; Cerebrovascular disease; MR spectroscopy; Ledipasvir/sofosbuvir
• ISSN: 1089-3261; 1557-8224
• DOI: 10.1016/j.cld.2017.03.008

The extrahepatic manifestations of hepatitis C include effects on the central nervous system, which have been associated with the ability of hepatitis C virus (HCV) to replicate in microglial and endothelial cells and the chronic inflammation induced by HCV. HCV can induce impaired neurocognition, which is clinically manifested by impaired quality of life, fatigue, and brain fog. These cognitive defects can be present even in patients with mild histologic HCV and have been confirmed by neurocognitive testing and brain imaging by magnetic resonance spectroscopy. Neurocognitive defects include loss of functioning memory and subtle changes in attention and processing speed.