HCV-related central and peripheral nervous system demyelinating disorders

Area of Science:

• Neurology
• Immunology
• Virology

Background:

• Chronic Hepatitis C Virus (HCV) infection is linked to diverse extrahepatic manifestations (EHMs), often immune-mediated.
• Neurological complications of HCV include axonal neuropathies and peripheral demyelinating disorders.
• Prompt diagnosis of HCV-related neurological issues is vital for effective treatment.

Purpose of the Study:

• To review demyelinating conditions associated with HCV.
• To report the increased frequency of chronic demyelinating neuropathy with anti-myelin-associated glycoprotein (MAG) antibodies in HCV patients.
• To present a case of neuromyelitis optica associated with anti-aquaporin-4 antibodies in an HCV patient.

Main Methods:

• Literature review of HCV-related demyelinating disorders.
• Analysis of a cohort of 59 consecutive HCV patients.
• Identification of specific autoantibodies, including anti-MAG and anti-aquaporin-4.

Main Results:

• A significantly increased frequency of chronic demyelinating neuropathy with anti-MAG antibodies was observed in the patient cohort.
• A second case of neuromyelitis optica with anti-aquaporin-4 antibodies was reported.
• HCV-associated demyelinating disorders represent an underrecognized spectrum of complications.

Conclusions:

• HCV infection is associated with a notable spectrum of demyelinating neurological disorders.
• Chronic demyelinating neuropathy with anti-MAG antibodies is more frequent in HCV patients than previously recognized.
• Recognition of these atypical HCV complications is crucial for patient management and treatment decisions.