Impact of early stages of (mild) hepatitis C viral infection on neurocognitive functions in otherwise healthy patients: an Egyptian magnetic resonance spectroscopy study

Abstract

Background The alterations in cerebral function in patients with chronic hepatitis C virus (HCV) infection may be due to a direct effect of HCV on the brain, or due to neurotoxic-related systemic inflammation. Objective This study aimed to assess central nervous system involvement through brain magnetic resonance spectroscopy (MRS) as well as cognitive functions in HCV-infected patients with mild liver disease. Patients and methods Twenty-eight HCV-infected patients with slightly elevated liver enzymes were recruited from the outpatient Hepatology Clinic, Beni Sweif University Hospitals and Ain Shams University Hospitals. They underwent cognitive examination by means of the Wechsler attention, concentration, and memory subscales, as well as cerebral MRS. The results of all investigations were compared with corresponding results of 15 matched normal controls. Results The results showed mild but significant elevation of liver enzymes in the patient group compared with the control group with impaired levels of attention, concentration, and memory determined by the subscales. MRS findings showed elevated choline and myoinositol in the basal ganglia, decreased N -acetyl aspartate, and abnormal N -acetyl aspartate/creatine ratio. Conclusion Treatment plans for HCV should consider neuropsychological complications.