Peripheral neuropathy in patients with hepatitis C virus infection: a clinical and neurophysiological study

Abstract

Background Hepatitis C virus (HCV)-positive patients may exhibit a wide range of extrahepatic manifestations, including peripheral neuropathy (PN). Aim The aim of this work was to study the incidence and patterns of PN among patients with HCV infection, with a special emphasis on the Egyptian HCV treatment protocol of direct-acting antiviral agents (DAAs). Patients and methods This was a case–control study carried out at the outpatient clinic of Neuropsychiatry and Tropical Medicine Departments in Tanta University Hospitals from August 2017 to April 2018. This study was applied on 60 patients with HCV infection targeting assessment of PN, clinically and neurophysiologically, before starting the Egyptian HCV treatment protocol of DAAs (visit 0) and 3 months later at the end of treatment with compliant drug therapy (visit 1), with follow-up of affected patients for 3 months after stoppage of treatment (visit 2). Results Clinical assessment of patients before treatment showed clinical diagnosis of neuropathy in 10% (6/60) of our patients, with sensory predominance, and by electrophysiology assessment, we found 15% (9/60) of our patients had PN, with sensory axonal type. After treatment, 30% (18/60) of our patients had a clinical evidence of PN with sensory predominance. By electrophysiology, 33.33% (20/60) of our patients were found with sensory axonal type. Follow-up showed partial regression of neuropathy at clinical and electrophysiological level. Conclusion DAAs induced PN in patients after receiving it at the end of treatment, with partial regression on follow-up.