HCV-related polyradiculoneuropathy in a HIV-positive man

P. Gazzola, A. De Maria, D. Mavilio, P. Costa, M. Fogli, B. Bruzzone, G. Icardi, L. Cocito, A. Primavera

Research output: Contribution to journalArticle

Abstract

Cases of acute polyneuroradiculopathy mimicking Guillain-Barré syndrome (GBS) have been described in HIV infection, often associated with mild CSF pleocytosis. We report a 42-year-old HIV-positive patient with an acute inflammatory polyradiculoneuropathy associated with subclinical HCV infection. He presented with rapidly progressing sensorimotor symptoms 2 weeks after an episode of fever and asthenia. EMG/ENG study indicated a demyelinating damage of motor and sensory nerves. CSF findings revealed 20 WBC/mmc, IgG intrathecal synthesis and oligoclonal bands, but no increase in proteins. He underwent plasmapheresis, and the clinical course improved within 1 month. Quantitative analysis of the HIV-1 and HCV viral load in paired plasma/CSF samples showed detectable amounts of HCV-RNA in CSF on clinical presentation and a subsequent decrease below quantification limits after plasmapheresis. Conversely, plasma HIV-1 viral load was persistently high after plasmapheresis, too, while there was an increase in HIV-1 RNA in CSF immediately after plasmapheresis, even if symptoms were improving. Moreover, the lack of HIV-1 specific cytolytic activity in CSF-derived CD8+ cells suggests that a cellular immune response against HIV-1 antigens was an unlikely cause of the disease. HCV infection has been associated with acute GBS only in a handful of patients, and no direct demonstration of viral genome in CSF is available, though recent works suggest that HCV may enter the CSF. Molecular studies in our patient would indicate a more likely association with HCV rather than HIV-1 infection.

Original languageEnglish
JournalNeurological Sciences
Volume21
Issue number4 SUPPL.
Publication statusPublished - 2000

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Polyradiculoneuropathy
HIV-1
Plasmapheresis
HIV
Viral Load
HIV Infections
HIV Antigens
RNA
Oligoclonal Bands
Asthenia
Asymptomatic Infections
Guillain-Barre Syndrome
Viral Genome
Leukocytosis
Cellular Immunity
Fever
Immunoglobulin G
Infection

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Gazzola, P., De Maria, A., Mavilio, D., Costa, P., Fogli, M., Bruzzone, B., ... Primavera, A. (2000). HCV-related polyradiculoneuropathy in a HIV-positive man. Neurological Sciences, 21(4 SUPPL.).

HCV-related polyradiculoneuropathy in a HIV-positive man. / Gazzola, P.; De Maria, A.; Mavilio, D.; Costa, P.; Fogli, M.; Bruzzone, B.; Icardi, G.; Cocito, L.; Primavera, A.

In: Neurological Sciences, Vol. 21, No. 4 SUPPL., 2000.

Research output: Contribution to journalArticle

Gazzola, P, De Maria, A, Mavilio, D, Costa, P, Fogli, M, Bruzzone, B, Icardi, G, Cocito, L & Primavera, A 2000, 'HCV-related polyradiculoneuropathy in a HIV-positive man', Neurological Sciences, vol. 21, no. 4 SUPPL..
Gazzola P, De Maria A, Mavilio D, Costa P, Fogli M, Bruzzone B et al. HCV-related polyradiculoneuropathy in a HIV-positive man. Neurological Sciences. 2000;21(4 SUPPL.).
Gazzola, P. ; De Maria, A. ; Mavilio, D. ; Costa, P. ; Fogli, M. ; Bruzzone, B. ; Icardi, G. ; Cocito, L. ; Primavera, A. / HCV-related polyradiculoneuropathy in a HIV-positive man. In: Neurological Sciences. 2000 ; Vol. 21, No. 4 SUPPL.
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