Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

ObjectiveTo study associations between viral hepatitis and Parkinson disease (PD).MethodsA retrospective cohort study was done by analyzing linked English National Hospital Episode Statistics and mortality data (1999-2011). Cohorts of individuals with hepatitis B, hepatitis C, autoimmune hepatitis, chronic active hepatitis, and HIV were constructed, and compared to a reference cohort for subsequent rates of PD.ResultsThe standardized rate ratio (RR) of PD following hepatitis B was 1.76 (95% confidence interval [CI] 1.28-2.37) (p < 0.001), based on 44 observed compared with 25 expected cases. The RR of PD following hepatitis C was 1.51 (95% CI, 1.18-1.9) (p < 0.001), based on 48.5 expected and 73 observed cases. There was no significant association between autoimmune hepatitis, chronic active hepatitis or HIV, and subsequent PD. When including only those episodes of care for PD that occurred first at least 1 year following each exposure condition, the RR for hepatitis B and hepatitis C were 1.82 (1.29-2.5) and 1.43 (1.09-1.84), respectively.ConclusionsWe report strong evidence in favor of an elevation of rates of subsequent PD in patients with hepatitis B and hepatitis C. These findings may be explained by factors peculiar to viral hepatitis, but whether it reflects consequences of infection, shared disease mechanisms, or the result of antiviral treatment remains to be elucidated. Further work is needed to confirm this association and to investigate pathophysiologic pathways, potentially advancing etiologic understanding of PD more broadly.

Original publication

DOI

10.1212/wnl.0000000000003848

Type

Journal article

Journal

Neurology

Publication Date

04/2017

Volume

88

Pages

1630 - 1633

Addresses

From the Unit of Health-Care Epidemiology (J.P., R.G., M.G.), Nuffield Department of Population Health, University of Oxford; and UCL Institute of Neurology (A.N., M.S., S.M., A.S., A.L.), Queen Square, London, UK.

Keywords

Humans, Hepatitis, Viral, Human, HIV Infections, Parkinson Disease, Medical Records, Retrospective Studies, Time Factors, Inpatients, State Medicine, England