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Minerva Psichiatrica 2019 June;60(2):91-9

DOI: 10.23736/S0391-1772.19.02012-0


language: English

Neurocognitive impairment and cerebral metabolic alterations induced by direct hepatitis C virus neuroinvasion: implications on quality of life

Silvana ZITO 1 , Simona MERCURIO 2, Giuseppe MERCURIO 3, Alessandro PIGONI 1, Gian Mario MANDOLINI 1, Elisabetta CALETTI 1

1 Department of Neurosciences and Mental Health, Ca’ Granda Foundation and Institute for Research and Care, Maggiore Polyclinic Hospital, University of Milan, Milan, Italy; 2 Department of Dermatology, Johannes Wesling Klinikum Minden, Bochum University Hospital, Bochum, Germany; 3 Department of Pediatrics, V. Buzzi Hospital, University of Milan, Milan, Italy

Several studies have demonstrated the capability of the hepatitis C virus (HCV) to invade brain cells; this has been suspected to cause symptoms in patients independent of liver disease status. Awareness of the quality of life deterioration, during chronic hepatitis C infection and its therapy, has led researchers to investigate neurocognitive and neuropsychiatric impairment in order to identify which factors could be predictable of deficits. This paper also notes the deleterious effect of interferon/ribavirin therapy on such symptoms. Among the techniques used in the reviewed research papers are imaging studies, neuropsychological tests, neurological examination, electroencephalography (EEG). The reviewed research papers included studies on cohorts of patients and heathy control studies (or different subgroups of therapy or conditions). This review highlights the relationship between HCV neuroinvasion, neuropsychological and neuropsychiatric disorders, and quality of life in HCV patients. In addition, HCV therapy with IFN and ribavirin is considered a risk factor that may exacerbate the underlying psychiatric disorders and can compromise the patients’ adherence to therapy. There is ample evidence that HCV neuroinvasion is responsible for neuropsychiatric and neurocognitive symptoms (regardless of liver disease state); these may be further worsened by IFN/RIB treatment. Nonetheless, the scarcity of studies and the methodological constraints pose a limitation to be overcome in further studies.

KEY WORDS: Hepatitis; Hepacivirus; Cognitive dysfunction; Quality of life

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