Pflugrad H, Meyer G-J, Dirks M, Raab P, Tryc A B, Goldbecker A, Worthmann H, Wilke F, Boellaard R, Yaqub M, Berding G, Weissenborn K
Department of Neurology, Hannover Medical School, Hannover, Germany.
Integrated Research and Treatment Centre Transplantation, Hannover Medical School, Hannover, Germany.
J Viral Hepat. 2016 May;23(5):348-57. doi: 10.1111/jvh.12496. Epub 2016 Jan 15.
Hepatitis C virus (HCV) infection may induce chronic fatigue and cognitive dysfunction. Virus replication was proven within the brain and HCV-positive cells were identified as microglia and astrocytes. We hypothesized that cerebral dysfunction in HCV-afflicted patients is associated with microglia activation. Microglia activation was assessed in vivo in 22 patients with chronic HCV infection compared to six healthy controls using [(11) C]-PK11195 Positron Emission Tomography (PET) combined with magnetic resonance tomography for anatomical localization. Patients were subdivided with regard to their PCR status, Fatigue Impact Scale score (FIS) and attention test sum score (ATS). A total of 12 patients (54.5%) were HCV PCR positive [of which 7 (58.3%) had an abnormal FIS and 7 (58.3%) an abnormal ATS], 10 patients (45.5%) were HCV PCR negative (5 (50%) each with an abnormal FIS or ATS). Patients without attention deficits showed a significantly higher accumulation of [(11) C]-PK11195 in the putamen (P = 0.05), caudate nucleus (P = 0.03) and thalamus (P = 0.04) compared to controls. Patients with and without fatigue did not differ significantly with regard to their specific tracer binding in positron emission tomography. Preserved cognitive function was associated with significantly increased microglia activation with predominance in the basal ganglia. This indicates a probably neuroprotective effect of microglia activation in HCV-infected patients.
丙型肝炎病毒（HCV）感染可能会导致慢性疲劳和认知功能障碍。已证实病毒可在大脑内复制，且HCV阳性细胞被鉴定为小胶质细胞和星形胶质细胞。我们推测，丙型肝炎患者的脑功能障碍与小胶质细胞激活有关。与6名健康对照者相比，使用[¹¹C]-PK11195正电子发射断层扫描（PET）结合磁共振断层扫描进行解剖定位，对22例慢性HCV感染患者的小胶质细胞激活情况进行了体内评估。根据患者的PCR状态、疲劳影响量表评分（FIS）和注意力测试总分（ATS）进行分组。共有12例患者（54.5%）HCV PCR呈阳性[其中7例（58.3%）FIS异常，7例（58.3%）ATS异常]，10例患者（45.5%）HCV PCR呈阴性（各有5例（50%）FIS或ATS异常）。与对照组相比，无注意力缺陷的患者在壳核（P = 0.05）、尾状核（P = 0.03）和丘脑（P = 0.04）中[¹¹C]-PK11195的蓄积明显更高。有疲劳和无疲劳的患者在正电子发射断层扫描中的特异性示踪剂结合方面无显著差异。认知功能保留与小胶质细胞激活显著增加有关，主要集中在基底神经节。这表明小胶质细胞激活在HCV感染患者中可能具有神经保护作用。
