Hepatitis C virus and peripheral neurological complications in Egyptian patients

Abstract 

Background and study aims

Neurological complications in HCV-infected patients occur predominantly in the peripheral nervous system. Vasculitic neuropathy is the most firmly linked neurologic illness associated with HCV infection. This type of neuropathy occurs frequently in the presence of cryoglobulinemia. HCV-related cranial neuropathies have been also reported. This study was conducted to investigate the various peripheral neurological complications of chronic hepatitis C infection and their possible pathogenetic mechanisms.

Patients and methods

This study was conducted on 160 patients with chronic hepatitis C infection comprised two subgroups: group I, composed of 80 chronic hepatitis C patients with clinically apparent neurological complication(s), and group II, composed of 80 chronic hepatitis C patients neurologically asymptomatic. Patients were subjected to clinical evaluation, estimation of hepatitis markers, cryoglobulins, anticardiolipin antibodies, antinuclear antibodies and nerve conduction studies.

Results

Peripheral neuropathies represented the most commonly encountered neurological disorders, occurring in 25 patients (31.25%). The sensory peripheral neuropathy was the most common type, representing 32% of neuropathic patients (8/25). A statistically significant difference was found between groups I and II regarding the presence of cryoglobulin and anticardiolipin antibody, being more common in group I. Antinuclear antibody was more common in group I than in group II. Results of nerve conduction studies showed nerves were more affected in group I and in cryoglobulin and ANA positive patients.

Conclusion

Peripheral neuropathies represent the most common HCV-related peripheral neurological disorders especially when associated with cryoglobulins and ANA antibodies.

Keywords: Hepatitis C infection, Neurological complications, Cryoglobulinaemia, Anticardiolipin, Antinuclear antibodies