Neuropathological and Neuropsychiatric Determinants in HCV-Infected Patients

Chronic hepatitis C virus (HCV) infection is a growing global health problem. HCV is a leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) and is associated with more than 30 extrahepatic manifestations (EHMs). Although cryoglobulinemia is the main pathological cause of neurologic EHMs, HCV viral replication in the brain itself must also be taken into consideration. The most significant neurological manifestations of HCV chronic infection are stroke, leukoencephalopathy, encephalomyelitis/myelitis, and peripheral neuropathy. The most significant neuropsychological manifestations of HCV infection are fatigue, depression, anxiety, and cognitive dysfunction. Antiviral HCV treatment should be the first-line treatment for managing mild-tomoderate vascular and neurologic symptoms; most of EHMs improve or even resolve if antiviral treatment starts on time.