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:
Correspondence to:
Professor L Santoro
Dipartimento di Scienze Neurologiche, Università degli Studi di Napoli "Federico II", Via Sergio Pansini 5, 80131 Napoli, Italy; lusantor{at}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

Keywords: HCV infection; peripheral neuropathy prevalence; cryoglobulinemia

This article has been cited by other articles:

				M. Casato, M. Carlesimo, A. Francia, C. Timarco, A. Antenucci, M. Bove, H. Martini, M. Visentini, M. Fiorilli, and L. Conti Influence of inherited and acquired thrombophilic defects on the clinical manifestations of mixed cryoglobulinaemia Rheumatology, August 19, 2008; (2008) ken303v1. [Abstract] [Full Text] [PDF]

				C. Briani, L. Chemello, G. Zara, M. Ermani, E. Bernardinello, S. Ruggero, E. Toffanin, A. Gatta, L. Battistin, and L. Cavalletto Peripheral neurotoxicity of pegylated interferon alpha: a prospective study in patients with HCV. Neurology, September 12, 2006; 67(5): 781 - 785. [Abstract] [Full Text] [PDF]