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Review
. 2021 Feb;92(2):144-149.
doi: 10.1007/s00115-020-00999-6. Epub 2020 Oct 1.

[Neurological complications of hepatitis C infections]

[Article in German]
Felix Kleefeld  1 , Gabriele Arendt  2 , Eva Neuen-Jacob  3 , Matthias Maschke  4 , Ingo Husstedt  5 , Mark Obermann  6 , Holger Schmidt  7 , Katrin Hahn  8 ; Deutsche Gesellschaft für Neuro-AIDS und Neuro-Infektiologie (DGNANI)
Affiliations
Review

[Neurological complications of hepatitis C infections]

[Article in German]
Felix Kleefeld et al. Nervenarzt. 2021 Feb.

Abstract
in English, German

Chronic hepatitis C virus (HCV) infection is a highly prevalent systemic disease, which can cause a variety of neurological complications. The HCV-associated symptoms can be differentiated into central and peripheral nervous systems as well as the musculature. Important pathomechanisms are HCV-associated autoimmunity (e.g. mixed cryoglobulinemia with polyneuropathy) and direct neurotoxic effects of the virus (e.g. HCV-associated cognitive deficits). Distal symmetric polyneuropathies, small fiber neuropathies and cognitive deficits are the most prevalent neurological manifestations. Furthermore, HCV infection is a risk factor for ischemic and hemorrhagic stroke as well as Parkinson's disease. As HCV infection has become a permanently curable disease in >90% of patients, early identification and antiviral treatment of HCV positive patients is of utmost importance.

Die chronische Hepatitis-C-Virus(HCV)-Infektion ist eine hochprävalente Systemerkrankung, die verschiedene neurologische Komplikationen verursachen kann. Es lassen sich HCV-assoziierte Symptome im zentralen und peripheren Nervensystem sowie der Muskulatur unterscheiden. Wichtige Pathomechanismen sind die HCV-assoziierte Autoimmunität (z. B. gemischte Kryoglobulinämie mit Polyneuropathie) und direkte Neurotoxizität (z. B. bei HCV-assoziierten kognitiven Defiziten). Die häufigsten neurologischen Komplikationen sind distal-symmetrische Polyneuropathien, Small-fiber-Neuropathien und kognitive Defizite. Die HCV-Infektion stellt außerdem einen Risikofaktor für ischämische und hämorrhagische Schlaganfälle sowie den Morbus Parkinson dar. Die frühe Identifikation und antivirale Behandlung HCV-positiver Patienten steht im Zentrum der Behandlung. Durch neue antivirale Therapien können >90 % der Patienten dauerhaft von der HCV-Infektion geheilt werden.

Keywords: Cognitive deficits; Cryoglobulinemia; Hepatitis C; Polyneuropathy; Small fiber neuropathy.

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