Does acute hepatitis C infection affect the central nervous system in HIV-1 infected individuals?
Central nervous system (CNS) manifestations of chronic hepatitis C virus (HCV) and chronic human immune deficiency virus-1 (HIV-1) infections have been reported, but the impact of acute HCV infection on the CNS is unknown. A total of 10 individuals with chronic stable HIV-1 with documented acute HCV (HCV-RNA polymerase chain reaction positive and HCV antibody negative, group 1) underwent cerebral proton magnetic resonance spectroscopy (MRS) using acquisition parameters to quantify myo-inositol/creatine (mI/Cr) ratio in the right basal ganglia (RBG). Two matched control groups also underwent MRS; group 2: ten with chronic HIV-1 and no evidence of HCV, and group 3: ten with no evidence of HIV or HCV. Subjects also underwent computerized neurocognitive assessments (CogState). RBG mI/Cr ratio in group 1 (acute HCV in a background of HIV) was significantly lower than that in groups 2 and 3 [2.90 (+/-0.7) vs 3.34 (+/-0.4) and 3.43 (+/-0.4), mean (SD) for group 1 vs 2 and 3 respectively, P = 0.049], with 50% of subjects in group 1 having a mI/Cr ratio below the lowest observed ratio in either of the other groups. On neurocognitive testing, significant defects in the monitoring domain were observed in group-1, compared with matched controls (P = 0.021). Acute HCV in HIV-1 infected subjects is associated with CNS involvement. Clinicians should be vigilant of early CNS involvement when assessing subjects with acute HCV.
Division of Medicine, Imperial College London, London, UK. a.winston@imperial.ac.uk
A
A
Winston
L
L
Garvey
E
E
Scotney
D
D
Yerrakalva
J M
JM
Allsop
E C
EC
Thomson
V P B
VP
Grover
J
J
Main
J I
JI
Cox
M
M
Wylezinska
S D
SD
Taylor-Robinson
D000328:Adult; D001479:Basal Ganglia / Q000737:chemistry / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging; D002493:Central Nervous System Diseases / Q000473:pathology*; D003072:Cognition Disorders / Q000473:pathology; D003404:Creatinine / Q000737:chemistry; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007294:Inositol / Q000737:chemistry; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D011859:Radiography
D007294:Inositol; D003404:Creatinine