Fulminant central nervous system demyelination associated with interferon- therapy and hepatitis C virus infection

[Myown]

I remember making a comment to someone on forum saying "isn't it odd that we seem to see so many people being dx with MS. I personally know several people. At that time, I said I wonder if this could somehow be related to HCV, since hardly any doctor checks people for HCV unless the patient themselves asks. Now here in this study it says that the person developed MS AFTER the interferon theraphy,,,but what IF the HCV did in fact cause the MS and the interferon only brought it out - as it seems to do with other diseases/autoimmune after tx. Notice it says "neuropathological confirmation of MS associated with IFN- therapy and HCV infection is lacking." I hope they start to research in this area soon. My brain scan did show change in white matter - now whether I had it before tx or after - I'll never know...BUT the only way doctors will know if the interferon is causing brain abnormalities (or if the abnormalities are there already from the HCV) is to INCLUDE a brain MRI as part of the HCV exam. Because really, we have a deadly disease that affects all of our organs and all we get for an exam prior to tx is a few pushes on our stomach and some blood tests - maybe an eye exam. Since we DO KNOW this disease affects our entire body/brain, there needs to be more tests prior and post tx - IMO.

I found this interesting and wanted to pass it on to those who may also find it interesting.


http://intl-msj.sagepub.com/cgi/content/abstract/13/9/1100

Hepatitis C virus (HCV) infection is common in the general population and may coincide with disease in the central and peripheral nervous system. Interferon- (IFN-) is used as treatment for HCV infection. The therapeutic benefit is assumed to result from activation of natural killer cells and CD8+ T cells. Despite its beneficial effects, it has been associated with a number of autoimmune disorders, such as chronic inflammatory demyelinating polyneuropathy and multiple sclerosis. Several clinical reports including magnetic resonance imaging exist, but neuropathological confirmation of MS associated with IFN- therapy and HCV infection is lacking. We report a case of a female patient with chronic HCV infection who developed `acute MS'-like demyelinating disease after IFN- administration, with extensive lesions throughout brain and thoracic spinal cord. The patient died after a disease duration of 6 months. Brain autopsy revealed Baló-like demyelinating plaques with positive HCV sequences within florid lesions. The development of fulminant demyelinating disease after administration of IFN- suggests that autoimmune mechanisms such as T cell mediated tissue damage might be initiated or aggravated by IFN- therapy. Additionally, the presence of HCV RNA within the demyelinated lesion indicates a possible role in triggering or propagating disease. Multiple Sclerosis 2007; 13: 1100—1106. http://msj.sagepub.com


Key Words: CD8+ T cells • concentric sclerosis (Baló) • hepatitis C virus • interferon- • multiple sclerosis (MS)

[beamishboy]

excellent,enlightening & disturbing thread.  

[alagirl]

I was previously well prior to gettiing hcv, except for the anemia, which was under control.  The day I began treatment, before I took my first shot, my doc did think to send me for an entire MRI series.  Now I had only had hepc for three months, but that MRI - which I just got my hands on - is horrible.  I'm pretty scared about it.  I'm going to go talk to my hematologist, since he happens to be an oncologist.  

Prior to this, all of my MRI's have been normal save for three small benign tumors in my liver.  Now I have a huge tumor on my ovary, a swollen inguinal lymph node, and this huge portion of bilateral gluteal fat stranding, more prominent on the left side.  the left side of my lower lung is scarred (I've NEVER had a serious cold or illness involving the lung), and I now have a splenule (that's new too).  I'm going to have them run my entire body through the PET scan.  That fat stranding can happen adjacent to cancerous tumors, and it also can happen due to infection.  I'm going to go pick up my other MRI's from Birmingham and see what the hell is going on.  Surely to God this couldn't be from just my three months of hepc, even though I got so sick from it?

[Myown]

Yup,I was hoping you saw this thread. I was going to PM you if you didn't. But it really hit me cause I think it was to you that I had just recently said - maybe in one of the "occult" threads - that doesn't it seem odd we are seeing so many people getting MS.

Now whether its the bodies own interferon in high gear trying to rid the HCV virus or maybe some other virus,,,but to me it seems plain as day that since the "artificial interferon" can cause MS - so would someones own interferon if over stimulated cause it.

But I do think everyone with MS should be tested for HCV and if neg, they should be checked for other viruses or anything that would cause their body to produce excess amounts of interferon.

Just as it seems that those that know they had hep c for many years,as non A non B, many times these people will have autoimune diseases - psoriasis etc.

And many of us have borderline ANA. I remember you said you do and so do I. Now if pushed over the border - who knows what will manifest. This I believe is why so many people come out ot tx with post tx sx......before tx their own interferon was in high gear causing borderline- but unable to identify - autoimmune diseases,,,but then add mucho interferon once tx starts and it pushes you over the hill into more symptoms of the underlying autoimmune disease or some even get full blown autoimmune disease.

[DoubleDose]

I think that it may boil down to a situation where either and both of the above may be responsible for creating these problems and diseases.  I think we have seen evidence that HCV alone can and does often cause a range of other serious diseases, in some people, aside from liver disease.  We also see clear evidence that the interferon can at times generate very serious syndromes, or actual disease processes on its own, and not only within previously HCV infected patients.  The last part of the equation is that HCV may also create the underlying mechanisms for various diseases to manifest, but it may be a long slow process.  The interferon, combined with the underlying HCV processes at work, may both together push serious diseases or syndromes into active mode in some people.  Ultimately there may never be a clear 'either/ or' answer to what is the real cause, because it may be that both the interferon and the HCV  act synergistically in many cases to cause these problems.  It could range from being totally due to the HCV in certain cases, to being any combination of the two, or at the other extreme, may be entirely due to reactions to the interferon, in others.

Now, the question of whether MS might be possibly caused by interferon, or HCV in some people seems to me to be very likely, and I would think that maybe this is because the interferon and the HCV really provoke similar responses by the body.  Maybe the HCV just does it in a less intense way, over longer, more gradual periods of time.  Probably in both cases we are looking at fallout and illnesses generated by immune system responses, and internal self-attack within various systems.   Maybe some people develop diabetes, or thyroid disease, and others develop EMC, vascular disease, or MS, Lupus, etc.  Most of it would be generated in similar ways, whether by the HCV or the Interferon.  That's my take on it anyway.

DoubleDose

[Myown]

I have major cog fog at the moment , I feel my responses to you are woefully inadequate . I do send my sincerest thanks and hope to get some brain power back so I can discuss this in greater depth with you or anyone who is interested .
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Your welcome.
You're doing fine. There are big brains on this forum and I am not one of them. We all try to provide information for one another to bring to our doctors. Always feel free to post and ask questions. Someone will always try to help.

Keep in touch with us all. I will most likely be going underground (only private messaging) once I start treatment and just come on when I need to ask questions,,,(and you can private message me whenever you like also.)

Good luck!

[cjacks]

OMG..     Thanks so much for all the info .  I have many questions for the docs. These sites will certainly  give them something to think about .  

I have major cog fog at the moment , I feel my responses to you are woefully inadequate . I do send my sincerest thanks and hope to get some brain power back so I can discuss this in greater depth with you or anyone who is interested .  

I would love to find more individuals who are having this experience .  I've tried going through the search , but didn't find much . I'm running out of steam already . I'll try more later

Jo