Clinical and neurophysiology study in hepatitis C virus patients

Background Hepatitis C virus is associated with extrahepatic organ involvement including the nervous system especially peripheral nervous system, which is frequently affected due to the presence of hyper cryoglobulinemia (CG). Sensory and axonal neuropathy is the most frequent presentation in association with hyper CG. Peripheral neuropathy (PN) may also be observed in the absence of hyper CG. Aim The aim of this work was to study peripheral neurological complications related to chronic hepatitis C infection and the possible pathogenic mechanisms of these complications. Patients and methods This study was conducted on 60 patients with chronic hepatitis C infection who were subdivided into two subgroups: group I is composed of 30 chronic hepatitis C patients with clinically apparent neurological complications and group II is composed of 30 chronic hepatitis C patients, who were neurologically asymptomatic. The patients were subjected to clinical evaluation, estimation of hepatitis markers, cryoglobulins, and nerve conduction studies. Results Overt peripheral neuropathies occurred in 42 (70%) patients, detected subclinically in 12 (40%) patients. The chronic sensory peripheral neuropathy was the most common type, representing 60% of neuropathic patients. A statistically significant difference was found between groups I (80%) and II (33.3%), regarding the presence of cryoglobulin, being more common in group I. Results of nerve conduction studies have shown that nerves were more affected in group I and in cryoglobulin positive patients especially in the lower limb. Conclusion Peripheral neuropathies represent the most common hepatitis C virus-related peripheral neurological disorders especially when associated with cryoglobulins