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HCV hepatitis associated with anticardiolipin antibody and a cerebrovascular accident. Response to interferon therapy
S D Malnick1, Y Abend, E Evron
1Department of Internal Medicine C, Kaplan Hospital, Rehovot, Israel.
Insights
Interferon treatment resolved anticardiolipin antibodies and hepatitis C virus (HCV) in a patient experiencing vision loss from lacunar infarction. This suggests a link between HCV, autoimmune antibodies, and neurological events.
Area of Science:
- Neurology
- Hepatology
- Immunology
Background:
- Chronic hepatitis C virus (HCV) infection can be associated with extrahepatic manifestations.
- Anticardiolipin antibodies (ACA) are linked to hypercoagulability and thromboembolic events.
- Lacunar brain infarction can lead to significant neurological deficits, such as visual field defects.
Observation:
- A 54-year-old male with chronic HCV presented with quadrihemianopsia due to a lacunar brain infarction.
- High titers of anticardiolipin antibodies (ACA) were detected during the patient's evaluation.
- The patient underwent a course of interferon therapy for his HCV infection.
Findings:
- Following interferon treatment, liver transaminase levels normalized and HCV RNA became undetectable.
- Concomitantly, anticardiolipin antibody titers disappeared.
- The patient experienced clinical stability with no recurrence of thromboembolic events or HCV activity.
Implications:
- This case highlights a potential link between chronic HCV, ACA, and cerebrovascular events.
- Interferon therapy may be effective in resolving both HCV infection and associated autoimmune antibody production.
- Successful treatment suggests a possible autoimmune mechanism contributing to the patient's neurological and thrombotic complications.
Abstract:
A 54-year-old man with chronic hepatitis C virus (HCV) developed quadrihemianopsia caused by lacunar brain infarction. Extensive evaluation revealed high titers of anticardiolipin antibodies (ACA). Following interferon treatment (6 x 10(6), three times a week for 2 months and 3 x 10(6) for another 7 months), liver transaminase levels decreased to normal, HCV RNA in blood was no longer detectable, concomitantly with the disappearance of the ACA. The patient remained clinically stable without evidence for either HCV activity (RNA) or ACA or further thromboembolic events.