Hepatitis C Linked to Parkinson’s Disease

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Infection with the hepatitis C virus (HCV) significantly increases the risk for Parkinson’s disease (PD), new research shows.

“The risk of developing PD is obviously multifactorial, and our study shows that hepatitis C virus infection can be one of the risk factors,” said lead investigator Hsin-Hsi Tsai, MD, Neurology Department, National Taiwan University Hospital, Taipei.

The positive association between HCV infection and PD has clinical implications in high endemic HCV areas such as Taiwan, said Dr Tsai. “More detailed neurological tests and functional images might help us detect early PD in anti-HCV–positive patients.”

The study was published online December 23 in Neurology.

The investigators found a 2.5-fold increased risk for PD in patients with HCV infection compared with controls (no HCV or HBV) (hazard ratio [HR], 2.5; 95% confidence interval [CI], 2.07 – 3.02).

An analysis stratified by age, sex, or comorbidity found that a positive association between HCV and PD was maintained in patients under age 65 years, men, or those with a combination of any of the comorbidities. Being male and having comorbidities could represent “hits” in the “second hit” theory of PD.

The theory, she said, is that HCV enters the central nervous system (CNS) by disrupting the integrity of the blood-brain barrier, altering dopaminergic neuronal transmission in the midbrain, and triggering neuro-inflammation, which results in neuronal damage. This damage could be the first “hit,” with second “hits” possibly including age, male sex, other environmental exposures (such as pesticides), and head injury.

The link between HCV infection and PD is supported by findings that this infection might release inflammatory cytokines, such as sICAM-1 and RANTES signaling, which may play a role in the pathogenesis of PD, said Dr Tsai.

Dementia Link

HCV infection has also been linked to dementia, another neurodegenerative disease. Although the mechanisms here are not well understood, it’s believed that a similar pathogenesis may be at play, said Dr Tsai.

Read more….http://www.medscape.com/viewarticle/856410

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