Neurological Complications Related to Treatment of Hepatitis C Virus Infection in Egyptian Patients

Background: Treatment of hepatitis c virus (HCV) may induce or increase incidence of neurological side effects that may reduce adherence to therapy & result in dose modifications with less response or discontinuation of interferon therapy reducing quality of life. Objectives: To study central & peripheral nervous system complications related to treatment of chronic HCV infection. Methods: Forty Egyptian patients with chronic HCV infection were subdivided into 2 subgroups: Group  (20 patients with clinically apparent neuropsychiatric manifestation) & Group  (20 neurologically asymptomatic patients). Patients were subjected to clinical, neuropsychological evaluation with different scales, hepatitis markers, EEG & MRI brain. Results: The commonest pre-treatment disorder was sensory peripheral neuropathy (30%) followed by chronic sensory motor polyneuropathy & tension-type headache each (20%) while commonest post-treatment disorder was fatigue (25%), depression (20%) & tension-type headache (20%) followed by cognitive impairment & insomnia, each 15%. The most treatment-relieved disorders were cranial neuropathies (100%) followed by sensory PN (83.3%). EEG changes increased significantly after HCV treatment in both studied groups and significant improvement of SCV, DL & amplitude of SAP of ulnar nerve & sural nerve in group I. In group II, the SCV & amplitude of SAP of ulnar nerve got significantly worse after treatment. The results of neuropsychological scales got worse after treatment in both studied groups. Conclusion: In HCV patient, we found a wide range of central &peripheral nervous system disorders linked to treatment either these disorders are induced or improved by treatment assessed by clinical, laboratory, neurophysiological & MRI. (Egypt J. Neurol. Psychiat. Neurosurg, 2009, 46(2): 287-298)