Fulminant central nervous system demyelination associated with interferon-α therapy and hepatitis C virus infection

R. Höftberger, F. Garzuly, H. P. Dienes, J. Grubits, B. Rohonyi, G. Fischer, Z. Hanzely, H. Lassmann, Herbert Budka

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19 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) infection is common in the general population and may coincide with disease in the central and peripheral nervous system. Interferon-α (IFN-α) is used as treatment for HCV infection. The therapeutic benefit is assumed to result from activation of natural killer cells and CD8+ T cells. Despite its beneficial effects, it has been associated with a number of autoimmune disorders, such as chronic inflammatory demyelinating polyneuropathy and multiple sclerosis. Several clinical reports including magnetic resonance imaging exist, but neuropathological confirmation of MS associated with IFN-α therapy and HCV infection is lacking. We report a case of a female patient with chronic HCV infection who developed 'acute MS'-like demyelinating disease after IFN-α administration, with extensive lesions throughout brain and thoracic spinal cord. The patient died after a disease duration of 6 months. Brain autopsy revealed Baló-like demyelinating plaques with positive HCV sequences within florid lesions. The development of fulminant demyelinating disease after administration of IFN-α suggests that autoimmune mechanisms such as T cell mediated tissue damage might be initiated or aggravated by IFN-α therapy. Additionally, the presence of HCV RNA within the demyelinated lesion indicates a possible role in triggering or propagating disease.

Original languageEnglish
Pages (from-to)1100-1106
Number of pages7
JournalMultiple Sclerosis
Volume13
Issue number9
DOIs
Publication statusPublished - Nov 1 2007

Keywords

  • CD8+ T cells
  • Concentric sclerosis (Baló)
  • Hepatitis C virus
  • Interferon-α
  • Multiple sclerosis (MS)

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Höftberger, R., Garzuly, F., Dienes, H. P., Grubits, J., Rohonyi, B., Fischer, G., Hanzely, Z., Lassmann, H., & Budka, H. (2007). Fulminant central nervous system demyelination associated with interferon-α therapy and hepatitis C virus infection. Multiple Sclerosis, 13(9), 1100-1106. https://doi.org/10.1177/1352458507078684