Positive People with Acute Hepatitis C Infection Show Neurocognitive
Winston from Imperial College London and colleagues sought to
assess neurological and cognitive function in HIV
positive people newly infected with HCV.
nervous system (CNS) manifestations of both chronic HIV and
chronic hepatitis C have been widely reported, and impairment
has been found to be worse when the 2 viruses co-exist. However,
the study authors noted as background, the effects of acute
HCV infection on the CNS in people with HIV are unknown.
small analysis included 10 individuals with chronic stable HIV-1
infection with documented acute HCV, as indicated by a positive
HCV RNA polymerase chain reaction assay but negative HCV antibody
test. These patients were compared with 2 matched control groups:
10 people with HIV but no evidence of HCV, and 10 with no evidence
of either HIV or HCV.
underwent cerebral proton magnetic resonance spectroscopy (MRS)
-- a technique for assessing brain function based on chemical
signatures -- to quantify myo-inositol/creatine (mI/Cr) ratio
in the right basal ganglia, which play a role in various brain
functions including motor control. The patients also received
computerized neurocognitive assessments.
basal ganglia mI/Cr ratio was significantly lower -- indicating
impaired function -- in the HIV positive patients compared
with the HIV-only and uninfected control groups (2.90, 3.34,
and 3.43 respectively; P = 0.049.
the participants in the acute coinfection group had a mI/Cr
ratio below the lowest observed ratio in either of the other
testing revealed that the HIV positive acute hepatitis C
group showed significant defects in the monitoring domain
(P = 0.021).
on these findings, the study authors concluded, "Acute
HCV in HIV-1 infected subjects is associated with CNS involvement."
they recommended, "Clinicians should be vigilant of early
CNS involvement when assessing subjects with acute HCV."
affiliations: Division of Medicine, Imperial College London,
London, UK; Department of HIV Medicine, Imperial College Healthcare
NHS Trust, St. Mary's Hospital, London, UK; Imaging Sciences
Department, MRC Clinical Sciences Centre, Imperial College London,
Winston, L Garvey, E Scotney, and others. Does acute hepatitis
C infection affect the central nervous system in HIV-1 infected
individuals? Journal of Viral Hepatitis 17(6): 419-426