Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 1

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Peripheral neuropathy (PN) has been found to be among the complications of hepatitis C virus (HCV) infection. Although the mechanisms of PN in patients with HCV infection are still unknown, cryoglobulinemia has been implicated as a possible cause of ischemic peripheral nerve impairment mediated by vasoconstriction, altered blood viscosity, and thrombosis of small vessels. However, available information is mostly based on referral patients with chronic HCV infection. In this study, an unselected sample of cases with newly diagnosed HCV infection has been examined to assess the prevalence and type of PN and to correlate the disease with the presence of cryoglobulinemia. The study population included 41 patients with HCV infection and no documented risk factors for PN (18 women and 23 men, aged 17 to 72 years) referred to the neurophysiology units of 7 Italian centers (Genova, Lodi, Messina, Monza, Napoli, Padova, and Siena) for a clinical and electrophysiological screening of peripheral nerve disease. The mean latency between diagnosis of HCV infection (interpreted as a surrogate of the duration of infection) and study entry was 6.8 months (range 1–12). PN was documented in 13 cases (31.7%). Of these, 7 had mononeuropathy and 6 had polyneuropathy. Cryoglobulinemia was present in 4 patients (9.8%) and 3 of them had PN (polyneuropathy 2, mononeuropathy 1). The odds ratio of PN in patients with cryoglobulinemia, adjusted for age, sex, and duration of infection, was 4.4 (95% confidence interval, CI: 0.3–68.2) and was fairly similar (4.1; 95% CI 0.3–56.3) when the analysis was limited to the presence of polyneuropathy. The lack of statistical significance may by explained by the small sample size. Based on these findings, cryoglobulinemia can be interpreted as an independent risk factor for PN at the presence of HCV infection. However, given the fairly high prevalence of PN in patients with newly diagnosed HCV infection and the high proportion of cases not attributable to cryoglobulinemia (9 out of 13), other factors should be investigated to clarify the mechanisms of HCV neuropathy.