Central Neuropsychiatric Complications of Hepatitis C Virus Infection in Egyptian Patients
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- Category: Vol. 77, June 2009
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Central Neuropsychiatric Complications of Hepatitis C Virus Infection in Egyptian Patients, AHMAD T. EL GHONEIMY, ADEL HASANIEN, GIHAN RAMZY, GAMAL ESSMAT, AHMAD ABOMOSA, AL METWALLY YOUSSOF, ZEINAB SHALABY and MOHAMAD EZZ EL-ARAB
Abstract
Rationale and Background: Central neuropsychiatric hepatitis C virus (HCV)-associated disorders have been described with increasing frequency in the literature. Anticar-diolipin antibodies (aCL) associated with HCV may be an important marker for the central neurological complications. Furthermore, cryoglobulinemia could be an important patho-genic factor for such complications.
Objectives: To study various central neuro-psychiatric complications of chronic hepatitis C infection and their possible pathogenetic mechanisms.
Methods: This study was conducted upon 160 Egyptian patients with chronic hepatitis C infection. They were subdi-vided into 2 subgroups: Group I which included 80 chronic hepatitis C patients with clinically apparent neuropsychiatric complication(s) and group II which included 80 chronic hepatitis C patients neuropsychiatric asymptomatic. The control group included 30 healthy volunteers as a control group for the neuropsychological evaluation. Patients were subjected to clinical neuropsychological evaluation, estimation of hepatitis markers, cryoglobulins, anticardiolipin antibodies, antinuclear antibodies, EEG, MRI brain.
Results: In neuropsychiatric manifested HCV patients, the most commonly encountered disorders were memory impairment and mood disorders each affected 11.7% of patients followed by fatigue which affected 10% of patients then cerebrovascular complications and tension-type headache each affected 8.3% of patients and in less frequency, late onset epilepsy, idiopathic intracranial hypertension and CNS infec-tions. There was highly statistical significant difference between both groups regarding the presence of cryoglobulin, anticardiolipin antibody, antinuclear antibody, EEG changes and MRI lesions being more common in group I.
Conclusion: Cognitive impairment, mood disorders, fa-tigue, cerebrovascular complications are common with HCV infection especially when associated with +ve cryoglobulins, ACL and antinuclear antibodies.