Study on HCV association w/ CNS dysfunction

[TnHepGuy_]

"Cerebral immune activation in chronic hepatitis C infection: A magnetic resonance spectroscopy study"

(from the paper):

""This study supports previously published data showing that HCV infection is associated with CNS dysfunction, and it is the first MRS study to show a significant correlation between neurocognitive deficits and changes in MR-measurable metabolites in patients with minimal hepatic inflammation. The results thus echo previous studies which have demonstrated this link between MRS and cognition in HIV infection. Furthermore, we propose that cerebral immune activation is a key concept in understanding the issues surrounding the effect that HCV has on the brain. The difficulty in clinical practice is that _-interferon-based treatments themselves exacerbate the situation, at least in the short to medium term. Whether successful viral eradication eventually results in normalization of these changes is not known, although improvements in health-related quality of life and fatigue scores after the end of antiviral therapy suggest that this may be the case. Longitudinal studies incorporating cognitive assessment and neuroimaging may in time provide the answer."

http://www.natap.org/2008/HCV/052708_06.htm


TnHepGuy

[frijole]

Well, I read the whole thing, but don't ask me for a translation.  Apparantely there is more white matter in the brains of people w/ Hep C and mild inflammation.  Why would we think that this virus that floats around our bodies in our blood stream would only affect the liver.  I am sure it affects every part of us.  Hopefully someone of a more scientific vent will come along and add comments.
frijole

[DoubleDose]

This is an area of great ijnterest to me, and gets to the issue of HCV's extrahepatic symptoms, during infection and after tx ends.  This CNS and Cerebral immune activation is potentially the cause for much of our fatigue, brain fog, personality and mood disorders, etc.  I think we have finally moved beyond the days when doctors thought our symptoms were either imaginary, or caused by the knowledge that we had a virus, or that the liver degradation and injury caused our problems.....there never was a strong correlation to any of these supposed causes.

I have always believed that either the virus itself, or its action on immune stimulating cells, in the brain and CNS was the real culprit for our problems.  In this same manner, I can also imagine that joint pains and arthritic problems associated with HCV could easily be from this same type of 'immune activation' focused on connective tissue.  How about those with severe gastric symptoms as a part of their HCV profile???  There may well be this same 'immune activation' taking place in soft gastric tissues.  This research answers many of the little understood questions about why we have so many wide ranging symptoms with HCV  (and some don't).  It may be a question of genetics, and which organs and cell structures in each person are sensitive to the virus, thus provoking intense 'immune activation' and resultant symptoms.

They (the article) ask the open ended question about whether these problems resolve after SVR...and that needs further research as well.  Maybe, just like the effects of interferon, the virus could stimulate cellular reactions that last far into the future, even after the virus is long gone.  The other possibility is that possibly after SVR, there could be sub-detectable, presistent virus remaining in many organs, thus silently and invisibly causing a long term 'immune activation' in those structures.  At any rate we need clearer answers to these questions if we ever hope to address the wide array of problems that HCV can cause.  They need to look at how our metabolism changes thus leading to diabetes, and what causes cardio-vascular degradation, connective tissue disorders, etc. etc.as a result of the long term virus.

All very interesting stuff.  Thanks for the info.

DoubleDose

[lbl1007]

Since this study says that hcv causes CNS disfunction can that include muscle weakness, movement disorders or tremor?

[mremeet]

Interesting, thanks for posting tn. I especially find these two comments of particular interest:

1. "Whether successful viral eradication eventually results in normalization of these changes is not known..."

Successful viral eradication? I guess the scientists who conducted this investigation believe that eradication is not only possible, but is actually what happens. And it's a recent study published in May of this year too.

2. "...although improvements in health-related quality of life and fatigue scores after the end of antiviral therapy suggest that this may be the case."

And obviously here they're claiming there is data (i.e. "scores") proving that QOL and fatigue are improved after successful treatment (probably embedded in one or more of their references). Once again, that flies in the face of much of what is [selectively] bandied about here (as in statement 1 above).

[DoubleDose]

I see that the foam, or is it the 'cooties' seem to follow me around on this site.  
Interesting change of subject anyway. I thought we were discussing the effects of HCV on the CNS and brain.  Little word phrases, and comments such as 'suggest this may be the case' must carry a lot of weight for the foam brigade.  

Of course the term 'viral eradication' has become a standard, boiler plate term for SVR, even used by those who study viral persistence at times.  I don't think the phrase is meant to be an 'absolute', nor that someone using it in an article means that we should stop considering the research on 'viral persistence'.  How simplistic!  Of course I remain completely open to the concept of total eradication, and am just looking for consensus at some point by the researchers, and final proof that eradication rather than remission is a 'fact'.  

On the other hand our foam sprayers have decided unilaterally what the answers are, and don't like any differing points of view.  They accept the data that they like, and disregard any conflicting evidence or research.  That's foam for you...can't see through it, and makes you slip and slide all over the place.

Of course someone new and  reading my post will wonder what in the heck I am talking about.  The 'foam'??  Well, I'll just say that if you read all the threads regularly, and go back and wade through the 'foam', you will quickly understand what I mean.  Sorry for my own turn down an alley, but I like to always provide a reply when prodded.  Keeps you on your toes,.... and from sliding on the foam.

DD

[mremeet]

"Foam sprayers?" LOL, that's a new one. For your information, I'm not a foam sprayer DD. The only thing I spray is something more akin to buttermilk and hand lotion, not foam. ;-)  And if I did spray foam, I'd (1) see a doctor ASAP, and (2) contact Ringling Bros for a lucrative new career.

As to: "Of course the term 'viral eradication' has become a standard, boiler plate term for SVR, even used by those who study viral persistence at times.  I don't think the phrase is meant to be an 'absolute', nor that someone using it in an article means that we should stop considering the research on 'viral persistence'."

Really? Well I guess you better have a chat with Dr. Dieterich then. Here's what he said recently right here at medhelp:

http://www.medhelp.org/posts/show/566007

"HCV is a flavivirus like dengue fever, yellow fever, west nile virus. It does not get into the nucleus of the cell and integrate into the genome like HBV or HCV [ed note: I think he means HIV here] does. Therefore when it is gone, it is really gone. totally cured! The late relapses occur because it was not all the way gone in some part of the body and was hiding out there, like in the brain or deep in the liver. We know that after 6 months relapses just dont occur. people can get reinfected with HCV, but late relapses just dont happen."

and...

http://www.medhelp.org/posts/show/564454

"There has been a cure for HCV since 1991. The response rates have increased steadily from about 6% then to about 60% now. The new drugs that we are using in clinical trials have increased that number to about 70%..."

In the meantime, I just wanted to congratulate you on your new video. Bravo!

http://youtube.com/watch?v=kwEHUxiJKr8