Evidence for a cerebral affect of the hepatitis C
Choline/creatine ratios are elevated in regions of the
brain of patients with hepatitis C, according to
research published in the latest issue of the Lancet.
A team from London, England, investigated whether
hepatitis C virus (HCV) affects cerebral function.
Patients with HCV infection frequently complain of
symptoms akin to the chronic fatigue syndrome. They
also score worse on health-related quality of life
indices than matched controls.
The researchers used proton magnetic-resonance
spectroscopy (1H MRS) to measure cerebral
choline/creatine ratios in subjects.
This suggests that a biological process underlies the
extrahepatic symptoms in chronic HCV infection.
This was performed in 30 patients with
histologically-defined mild chronic HCV infection, 29
age-matched and sex-matched healthy controls, and in
12 patients with chronic hepatitis B.
They found that the choline/creatine ratios were
significantly higher in the white matter and basal
ganglia of the HCV group, compared with both the
hepatitis B group and healthy volunteers.
This elevation was found to be unrelated to hepatic
encephalopathy or a history of intravenous drug abuse.
Daniel M Forton, of Imperial College School of
Medicine, St Mary's Hospital, London, concluded on
behalf of the group, "The elevation in
choline/creatine ratios suggests that a biological
process underlies the extrahepatic symptoms in chronic
"These findings have implications for the direction of
future research and ultimately for patient treatment."
Lancet 2001; 358: 38-9
10 July 2001
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