January 14, 2011

The liver-cytokine-brain circuit in interferon-based treatment of patients with chronic viral hepatitis

Journal of Viral Hepatitis
Early View (Articles online in advance of print)

C. Stasi, A. L. Zignego, G. Laffi, M. Rosselli

Article first published online: 7 JAN 2011
DOI: 10.1111/j.1365-2893.2010.01418.x
© 2011 Blackwell Publishing Ltd

Author Information
Department of Internal Medicine, University of Florence, Florence, Italy
*Correspondence: Cristina Stasi, MD, Dipartimento di Medicina Interna, Viale G.B. Morgagni, 85, 50134 Firenze, Italy. E-mail: cristina.stasi@unifi.it


chronic viral hepatitis;cytokines;interferon;interleukins;psychological disorders

Summary.  Psychiatric symptoms are commonly identified in patients with viral hepatitis. They may have been present prior to the onset of disease and may include symptoms related to addiction issues. Furthermore, the virus and antiviral therapy, in particular interferon, may induce or modify psychiatric symptoms. Recent data support chronic hepatitis C replication in the brain and subsequent changes of cerebral metabolite spectra and magnetic resonance alterations. In chronic viral hepatitis and in other chronic inflammatory diseases, an alteration of the neuro-endocrine-immune system response has been observed. Catecholamines and glucocorticoids modulate this immune/inflammatory reaction. Psychiatric assessment and monitoring before, during and after antiviral therapy can identify patients whose psychiatric symptoms preclude therapy, and those who may benefit from psychopharmacological therapy and counselling, thereby improving therapeutic results. This review will discuss current insights into the complex interplay between cytokines, liver and brain in chronic viral hepatitis closely associated with psychiatric issues, especially in the case of antiviral therapy, with the aim of indicating future research and possible treatments.


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