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Published Online First: 7 February 2006.
doi:10.1136/jnnp.2005.081570
Journal of Neurology, Neurosurgery, and Psychiatry 2006;77:626-629
© 2006 by BMJ
Publishing Group Ltd
Prevalence and characteristics of peripheral
neuropathy in hepatitis C virus population
L Santoro1,
F Manganelli1, C Briani2,
F Giannini3, L Benedetti4,
E Vitelli5, A Mazzeo6,
E Beghi7 HCV Peripheral Nerve Study Group*
1 Department of Neurological Sciences,
University of Naples "Federico II", Napoli, Italy
2 Department of Neurosciences, University of Padova, Italy
3 Department of Neurosciences, University of Siena, Italy
4 Department of Neurosciences, Ophthalmology and Genetic, and
Centre for Biomedical Research, University of Genova, Italy
5 Department of Neurology, Hospital "Maggiore", Lodi, Italy
6 Department of Neurosciences, Psychiatric and
Anaesthesiological Sciences, University of Messina, Italy
7 Department of Neurology, University of Milano-Bicocca,
Monza, Italy
Correspondence to:
Professor L Santoro
Dipartimento di Scienze Neurologiche, Universitą degli Studi di Napoli
"Federico II", Via Sergio Pansini 5, 80131 Napoli, Italy;
lusantor@unina.it
Objective: To assess the prevalence of peripheral
neuropathy (PN) and its correlation with cryoglobulinemia
(CG) in an unselected, untreated referral hepatitis C virus
(HCV) population.
Patients and Methods: Two hundred and thirty four patients
(120 women and 114 men) with untreated HCV infection were
consecutively enrolled by seven Italian centres. Clinical
neuropathy was diagnosed when symptoms and signs of
peripheral sensory or motor involvement were present. Median,
ulnar, peroneal, and sural nerves were explored in all
patients and distal symmetric polyneuropathy was diagnosed
when all explored nerves or both lower limb nerves were
affected. Mononeuropathy and mononeuropathy multiplex were
diagnosed when one nerve or two non-contiguous nerves with asymmetrical
distribution were affected. Screening for CG was done in 191
unselected patients.
Results: Clinical signs of PN were observed in 25 of the 234
patients (10.6%). Electrophysiological PN was found in 36 (15.3%).
CG was present in 56/191 patients (29.3%). The prevalence of
CG increased significantly with age (p<0.001) and disease
duration (p<0.05). PN was present in 12/56 (21%) patients
with CG and 18/135 (13%) without CG (p = NS). PN increased
significantly with age (p<0.001) and logistic regression
analysis confirmed age as the only independent predictor of
PN (OR 1.10 for each year; 95% CI 1.04 to 1.15; p<0.001).
Conclusions: Electrophysiological examination detected
subclinical neuropathy in 11 patients (4.7%). Statistical
analysis showed that CG was not a risk factor for PN whereas
PN prevalence increased significantly with age.
Abbreviations: CG, cryoglobulinaemia; CMAP, compound
motor action potential; DL, distal latency; HCV, hepatitis C virus; MCV,
motor conduction velocity; NCS, nerve conduction study; PCR, polymerase
chain reaction; PN, peripheral neuropathy; SAP, sensory action
potential; SCV, sensory nerve conduction velocity
http://jnnp.bmjjournals.com/cgi/content/abstract/77/5/626
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