Chronic hepatitis C virus infection and neurological and psychiatric disorders: an overview.
Hepatitis C virus (HCV) infection is considered a systemic disease because of involvement of other organs and tissues concomitantly with liver disease. Among the extrahepatic manifestations, neuropsychiatric disorders have been reported in up to 50% of chronic HCV infected patients. Both the central and peripheral nervous system may be involved with a wide variety of clinical manifestations. Main HCV-associated neurological conditions include cerebrovascular events, encephalopathy, myelitis, encephalomyelitis, and cognitive impairment, whereas "brain fog", depression, anxiety, and fatigue are at the top of the list of psychiatric disorders. Moreover, HCV infection is known to cause both motor and sensory peripheral neuropathy in the context of mixed cryoglobulinemia, and has also been recently recognized as an independent risk factor for stroke. These extrahepatic manifestations are independent of severity of the underlying chronic liver disease and hepatic encephalopathy. The brain is a suitable site for HCV replication, where the virus may directly exert neurotoxicity; other mechanisms proposed to explain the pathogenesis of neuropsychiatric disorders in chronic HCV infection include derangement of metabolic pathways of infected cells, alterations in neurotransmitter circuits, autoimmune disorders, and cerebral or systemic inflammation. A pathogenic role for HCV is also suggested by improvement of neurological and psychiatric symptoms in patients achieving a sustained virologic response following interferon treatment; however, further ad hoc trials are needed to fully assess the impact of HCV infection and specific antiviral treatments on associated neuropsychiatric disorders.
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Luigi Elio
LE
Adinolfi
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Riccardo
R
Nevola
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Giacomo
G
Lus
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Luciano
L
Restivo
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Barbara
B
Guerrera
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Ciro
C
Romano
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Rosa
R
Zampino
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Luca
L
Rinaldi
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Ausilia
A
Sellitto
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Mauro
M
Giordano
Luigi Elio Adinolfi, Clinical Hospital of Marcianise, Second University of Naples, 81025 Marcianise (CE), Italy.
Aldo
A
Marrone
D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D002490:Central Nervous System / Q000187:drug effects / Q000503:physiopathology / Q000821:virology*; D020805:Central Nervous System Viral Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000821:virology*; D016174:Hepacivirus / Q000187:drug effects / Q000472:pathogenicity*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000821:virology*; D016896:Treatment Outcome
D000998:Antiviral Agents
Hepatitis C virus; Inflammation; Neurological disorders; Psychiatric disorders; Stroke