Hjerrild Simon, Renvillard Signe Groth, Leutscher Peter, Sørensen Leif Hougaard, Østergaard Leif, Eskildsen Simon Fristed, Videbech Poul
Department for Affective Disorders, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark.
Center of Functionally Integrative Neuroscience (CFIN), Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Metab Brain Dis. 2016 Apr;31(2):311-9. doi: 10.1007/s11011-015-9752-3. Epub 2015 Nov 3.
Hepatitis C virus (HCV) infection is associated with fatigue, depression, and cognitive impairment even in the absence of severe liver fibrosis or cirrhosis. HCV has been hypothesised to cause neurodegenerative changes through low-grade neuroinflammation. Our aim was to examine whether cortical thickness (CTh) differs between chronic HCV patients and healthy controls, suggestive of cortical atrophy. In this case-control study 43 HCV patients without severe liver fibrosis, substance abuse, or comorbid HIV or hepatitis B virus infection, and 43 age and sex matched controls underwent MRI. Cortical thickness was measured using a surface based approach. Participants underwent semi-structured psychiatric interview and fatigue was assessed using the fatigue severity scale. HCV was associated with higher fatigue scores, and 58 % of HCV patients suffered from significant fatigue (p < 0.0001). Depression was observed in 16 % of patients. Areas of significantly reduced CTh were found in both left and right occipital cortex and in the left frontal lobe after correction for multiple comparisons (p < 0.05). No association between fatigue, former substance abuse, or psychotropic medication and CTh was found. No overall difference in cerebral white and grey matter volume was found. The findings support the hypothesis that HCV is associated with neurodegenerative changes.
丙型肝炎病毒（HCV）感染即使在没有严重肝纤维化或肝硬化的情况下，也与疲劳、抑郁和认知障碍有关。据推测，HCV通过低度神经炎症导致神经退行性变化。我们的目的是检查慢性HCV患者与健康对照之间的皮质厚度（CTh）是否不同，这表明存在皮质萎缩。在这项病例对照研究中，43名无严重肝纤维化、药物滥用或合并HIV或乙型肝炎病毒感染的HCV患者以及43名年龄和性别匹配的对照者接受了MRI检查。使用基于表面的方法测量皮质厚度。参与者接受了半结构化精神科访谈，并使用疲劳严重程度量表评估疲劳情况。HCV与更高的疲劳评分相关，58%的HCV患者患有严重疲劳（p<0.0001）。16%的患者观察到抑郁。在进行多重比较校正后，在左、右枕叶皮质和左额叶发现了CTh显著降低的区域（p<0.05）。未发现疲劳、既往药物滥用或精神药物与CTh之间存在关联。未发现脑白质和灰质体积存在总体差异。这些发现支持了HCV与神经退行性变化有关的假说。
