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Lower risk of multiple sclerosis in patients with chronic hepatitis C: a nationwide population-based registry study
Jonas Söderholm1,2, Aylin Yilmaz3, Anders Svenningsson4
1AbbVie AB, Hemvärnsgatan 9, Solna, Box 1523, 171 29, Stockholm, Sweden. jonas.soderholm@abbvie.com.
Background:
Multiple sclerosis (MS) is an immune-mediated neurological disease that causes demyelination. The etiology is unknown, but patients with a previous viral infection, such as Epstein-Barr virus, have been shown to be at a higher risk of developing MS. In contrast, people living with HIV have a lower risk of developing MS. Hepatitis C virus (HCV) mainly infects the liver, but patients with HCV can experience several extrahepatic manifestations and studies have shown an association with several autoimmune conditions such as neuropathy and myelitis. The present study aimed to investigate the risk of MS in patients with chronic HCV infection compared with matched comparators.
Methods:
Patients were identified using the nationwide Swedish inpatient (2001-2013) and outpatient care registers (2001-2013) for HCV (B18.2) and MS (G35) according to the International Classification of Diseases-10. Up to five comparators (matched on age/sex/place of residency) were drawn from the general population for each HCV patient. Follow-up started at the first HCV visit from 2001 and the patients' accrued person-time until death, emigration or 31 December 2013. Risk of MS diagnosis was calculated as standardized incidence ratio (SIR) with 95% confidence intervals (CIs).
Results:
HCV patients were at lower risk of MS diagnosis (SIR 0.37; 95% CI 0.26-0.50). The incidence of MS during the study in the HCV cohort was 0.087% compared with 0.27% in the matched comparator cohort.
Conclusion:
Surprisingly, these data suggest HCV patients to have a lower risk of MS diagnosis.
Insights
People with Hepatitis C virus (HCV) infection show a reduced risk of developing Multiple Sclerosis (MS). This study found a lower incidence of MS in HCV patients compared to the general population.
Area of Science:
- Neurology
- Immunology
- Virology
Background:
- Multiple sclerosis (MS) is an immune-mediated demyelinating neurological disease with unknown etiology.
- Viral infections, like Epstein-Barr virus, are linked to increased MS risk, while HIV infection is associated with lower MS risk.
- Hepatitis C virus (HCV) infection, primarily hepatic, can cause extrahepatic manifestations and is linked to autoimmune conditions.
Purpose of the Study:
- To investigate the association between chronic Hepatitis C virus (HCV) infection and the risk of developing Multiple Sclerosis (MS).
Main Methods:
- Utilized Swedish nationwide healthcare registers (2001-2013) to identify patients with HCV (B18.2) and MS (G35).
- Matched each HCV patient with up to five comparators from the general population based on age, sex, and residency.
- Calculated the standardized incidence ratio (SIR) of MS diagnosis in HCV patients versus comparators.
Main Results:
- HCV patients exhibited a significantly lower risk of MS diagnosis, with a SIR of 0.37 (95% CI 0.26-0.50).
- The incidence of MS was 0.087% in the HCV cohort, compared to 0.27% in the matched comparator cohort.
Conclusions:
- The findings indicate a surprisingly lower risk of Multiple Sclerosis (MS) diagnosis among patients with chronic Hepatitis C virus (HCV) infection.
- This suggests a potential protective or modulatory effect of HCV infection on MS development.
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