Division of Medicine, Imperial College London, London, UK.
J Viral Hepat. 2010 Jun;17(6):419-26. doi: 10.1111/j.1365-2893.2009.01198.x. Epub 2009 Sep 25.
Central nervous system (CNS) manifestations of chronic hepatitis C virus (HCV) and chronic human immune deficiency virus-1 (HIV-1) infections have been reported, but the impact of acute HCV infection on the CNS is unknown. A total of 10 individuals with chronic stable HIV-1 with documented acute HCV (HCV-RNA polymerase chain reaction positive and HCV antibody negative, group 1) underwent cerebral proton magnetic resonance spectroscopy (MRS) using acquisition parameters to quantify myo-inositol/creatine (mI/Cr) ratio in the right basal ganglia (RBG). Two matched control groups also underwent MRS; group 2: ten with chronic HIV-1 and no evidence of HCV, and group 3: ten with no evidence of HIV or HCV. Subjects also underwent computerized neurocognitive assessments (CogState). RBG mI/Cr ratio in group 1 (acute HCV in a background of HIV) was significantly lower than that in groups 2 and 3 [2.90 (+/-0.7) vs 3.34 (+/-0.4) and 3.43 (+/-0.4), mean (SD) for group 1 vs 2 and 3 respectively, P = 0.049], with 50% of subjects in group 1 having a mI/Cr ratio below the lowest observed ratio in either of the other groups. On neurocognitive testing, significant defects in the monitoring domain were observed in group-1, compared with matched controls (P = 0.021). Acute HCV in HIV-1 infected subjects is associated with CNS involvement. Clinicians should be vigilant of early CNS involvement when assessing subjects with acute HCV.
慢性丙型肝炎病毒（HCV）和慢性人类免疫缺陷病毒-1（HIV-1）感染可引起中枢神经系统（CNS）表现，但急性 HCV 感染对 CNS 的影响尚不清楚。共有 10 名慢性稳定 HIV-1 患者伴有明确的急性 HCV（HCV-RNA 聚合酶链反应阳性，HCV 抗体阴性，组 1），采用采集参数进行脑质子磁共振波谱（MRS），以定量右基底节（RBG）中的肌醇/肌酸（mI/Cr）比值。还对两组匹配的对照组进行了 MRS；组 2：10 名慢性 HIV-1 且无 HCV 证据，组 3：10 名无 HIV 或 HCV 证据。受试者还接受了计算机神经认知评估（CogState）。组 1（HIV 背景下的急性 HCV）的 RBG mI/Cr 比值明显低于组 2 和组 3 [2.90（+/-0.7）比 3.34（+/-0.4）和 3.43（+/-0.4），组 1 分别与组 2 和组 3 的平均值（SD），P=0.049]，组 1 中有 50%的受试者的 mI/Cr 比值低于其他两组中观察到的最低比值。在神经认知测试中，与匹配的对照组相比，组 1 中监测域存在明显的缺陷（P=0.021）。HIV-1 感染患者的急性 HCV 与 CNS 受累有关。当评估急性 HCV 患者时，临床医生应警惕早期 CNS 受累。
