Does Acute Hepatitis C Infection Affect the Central Nervous System in HIV-1 Infected Individuals?

A. Winston; L. Garvey; E. Scotney; D. Yerrakalva; J. M. Allsop; E. C. Thomson; V. P. B. Grover; J. Main; J. I. Cox; M. Wylezinska; S. D. Taylor-Robinson

Disclosures

J Viral Hepat. 2010;17(6):419-426. 

In This Article

Results

Patient Characteristics

A total of 10 individuals were recruited into each of the three study groups (Table 1). Subjects with acute HCV and chronic HIV-1 infection (group 1) all had detectable HCV viraemia at the time of study entry and a previous negative HCV Ab test in the past 8 months (mean 4.8 months). These cases (group 1) were carefully matched to HIV-1 infected subjects without HCV infection (group 2). Between these groups, age, CD4+ lymphocyte count and numbers on ART were similar. The risk factor for HCV transmission and HIV transmission in both groups was sexual (MSM).

Cerebral Metabolite Ratios

No statistically significant differences were observed in metabolite ratios between the three study groups in the FWM or FGM (Table 2). In the RBG, mI/Cr ratio was significantly lower in group 1 compared with that in groups 2 and 3 (P = 0.023). Of the patients in group 1, 50% had a mI/Cr ratio below the lowest ratio levels observed in either group 2 or 3 (Fig. 2). No differences in other metabolite ratios were observed.

Figure 2.

Box plot of mI/Cr ratios in right basal ganglia between study groups.

Detectable plasma HIV viral load was also significantly associated with RBG mI/Cr ratio, whereas plasma HCV viral load detected by quantitative PCR did not show this association (Table 3). In a multivariate analysis, both plasma HIV RNA and the presence of acute HCV infection (group 1) were associated with RBG mI/Cr ratio (P = 0.021 and 0.041 respectively). No association with HCV genotype was observed.

Computerized Neurocognitive Testing

A total of 8 subjects with acute HCV in group 1 underwent neurocognitive testing. The other two subjects declined to participate in these tests; no demographic differences existed between those who did and did not undergo neurocognitive testing. Compared with a control group of 45 HIV-1 infected subjects of a similar age, a significant impairment in the monitoring domain was observed in the acute HCV and HIV group (P = 0.021, r = 0.315) (Table 4). This finding was not significantly associated with age, time since HIV diagnosis, current CD4+ lymphocyte count, plasma HIV RNA or any cerebral metabolite ratios (P > 0.20 for all tests).

Although not statistically significant, a reduction in the 'detection' domain was observed in the acute HCV group (P = 0.092, r = 0.234).

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