Clifford D B, Smurzynski M, Park L S, Yeh T-M, Zhao Y, Blair L, Arens M, Evans S R
Washington University, St. Louis, MO 63110, USA.
Neurology. 2009 Jul 28;73(4):309-14. doi: 10.1212/WNL.0b013e3181af7a10.
Hepatitis C virus (HCV) is a frequent copathogen with HIV. Both viruses appear to replicate in the brain and both are implicated in neurocognitive and peripheral neuropathy syndromes. Interaction of the viruses is likely to be complicated and better understanding of the contributions of each virus will be necessary to make evidence-based therapeutic decisions.
This study was designed to determine if active HCV infection, identified by quantitative HCV RNA determination, is associated with increased neurocognitive deficits or excess development of distal sensory peripheral neuropathy in HIV coinfected patients with stable HIV viral suppression. The AIDS Clinical Trials Group Longitudinal Linked Randomized Trials (ALLRT) study was the source of subjects with known HIV treatment status, neurocognitive and neuropathy evaluations, and HCV status. Subjects were selected based on HCV antibody status (249 positive; 310 negative).
HCV RNA viral loads were detectable in 172 participants with controlled HIV infection and available neurologic evaluations in the ALLRT. These participants were compared with 345 participants with undetectable HCV viral load and the same inclusion criteria from the same cohort. Neurocognitive performance measured by Trail-Making A or B and digit symbol testing was not dissimilar between the 2 groups. In addition, there was no significant association between active HCV replication and distal sensory neuropathy.
Clinically significant neurocognitive dysfunction and peripheral neuropathy were not exacerbated by active hepatitis C virus infection in the setting of optimally treated HIV infection.
丙型肝炎病毒（HCV）是一种常见的与HIV共同感染的病原体。两种病毒似乎都在大脑中复制，并且都与神经认知和周围神经病变综合征有关。病毒之间的相互作用可能很复杂，更好地了解每种病毒的作用对于做出基于证据的治疗决策是必要的。
本研究旨在确定通过定量HCV RNA测定确定的活动性HCV感染是否与HIV合并感染且HIV病毒抑制稳定的患者神经认知缺陷增加或远端感觉性周围神经病变过度发展有关。艾滋病临床试验组纵向关联随机试验（ALLRT）研究是具有已知HIV治疗状态、神经认知和神经病变评估以及HCV状态的受试者的来源。根据HCV抗体状态选择受试者（249例阳性；310例阴性）。
在ALLRT中，172名HIV感染得到控制且有可用神经学评估的参与者中可检测到HCV RNA病毒载量。将这些参与者与来自同一队列、HCV病毒载量不可检测且纳入标准相同的345名参与者进行比较。两组之间通过连线测验A或B以及数字符号测试测量的神经认知表现没有差异。此外，活动性HCV复制与远端感觉性神经病变之间没有显著关联。
在最佳治疗的HIV感染情况下，活动性丙型肝炎病毒感染不会加剧具有临床意义的神经认知功能障碍和周围神经病变。
