Neurocognitive Impairment And Cerebral Metabolic Alterations Induced By Direct Hepatitis C Virus Neuroinvasion: Implications On Quality Of Life

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 am 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.