Cognitive function in hepatitis C patients with advanced fibrosis enrolled in the HALT-C trial

Fontana, Robert J.; Bieliauskas, Linas A.; Back-Madruga, Carla; Lindsay, Karen L.; Kronfol, Ziad; Lok, Anna S.; Padmanabhan, Latha; Group, the HALT-C Trial

doi:10.1016/j.jhep.2005.04.006

Cited by 76 publications

(82 citation statements)

References 47 publications

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“…2,5,28 A battery of 10 standardized neuropsychological tests was selected to detect subtle changes in multiple domains of cognitive function over time. [7][8][9] In addition to comparing individual test The frequency of cognitive impairment in the 177 patients treated in the lead-in phase of HALT-C did not significantly change between week 0 and week 24 (32% versus 34%, P ϭ 0.64). In addition, the frequency of impairment did not correlate with suppression of HCV RNA to undetectable levels in the 68 virological responders compared to the 109 patients who remained HCV RNA-positive (P ϭ 0.58).…”

Section: Discussionmentioning

confidence: 99%

“…9,17 The battery included tests designed to assess differing domains of cognitive function as follows: verbal memory using the selective reminding test; nonverbal memory using the continuous visual memory test; speed and efficiency of information processing using the serial digit learning, digit span test, and digit symbol test from the Wechsler Adult Intelligence Scale; visuomotor tracking using the simple reaction time, choice reaction time, and Trail's A and B; executive function using the Wisconsin card sorting test (WCST); and verbal processing using the Controlled Oral Word Association test (COWAT). The testretest reproducibility varied from 0.62 for simple reaction time to 0.78 and 0.85 for digits forward and backward, respectively, and 0.80 and 0.92 for Trail's A and B, respectively.…”

Section: Cognitive Functionmentioning

confidence: 99%

“…7,8 Subtle abnormalities in cognitive function have also been described in patients with chronic hepatitis C not receiving antiviral therapy. [8][9][10] The cause of these abnormalities is not known; however, possibilities include a direct effect of HCV, which may replicate in neurons as well as the effects of systemic cytokines, concomitant psychiatric disease, and subclinical hepatic encephalopathy. 11 The Hepatitis C Antiviral Long-term Treatment Against Cirrhosis Trial (HALT-C) is a prospective multicenter study designed to investigate the potential benefit of maintenance therapy with peginterferon in reducing the rate of clinical outcomes in prior nonresponders with advanced fibrosis.…”

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Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C†‡

et al. 2007

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Treatment of chronic hepatitis C with pegylated interferon (peginterferon) and ribavirin can cause or exacerbate depression but its effects on cognitive function are largely unknown. The aim of this study was to determine whether treatment with peginterferon and ribavirin adversely impacts cognitive function in patients with chronic hepatitis C. Prior nonresponders to interferon were retreated with peginterferon alfa-2a and ribavirin for 24 (n ‫؍‬ 177) or 48 weeks (n ‫؍‬ 57) in the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis trial. Cognitive function was prospectively assessed using a battery of 10 standardized neuropsychological tests at weeks 0, 24, 48, and 72. Cognitive impairment was defined based upon a global deficit score. The Beck Depression Inventory and Brief Symptom Inventory were used to assess mood status. The 57 subjects who completed 48 weeks of antiviral therapy reported significant increases in difficulty concentrating, emotional distress, and symptoms of depression, all of which improved after cessation of therapy [P < 0.0001, analysis of variance (ANOVA)]. Nonetheless, the frequency of cognitive impairment did not increase during the first 24 weeks of treatment in 177 patients (34% versus 32%, P ‫؍‬ 0.64) nor in the 57 patients completing 48 weeks of treatment (P ‫؍‬ 0.48, ANOVA). Conclusion: Retreatment of prior non-responders with peginterferon and ribavirin was not associated with objective evidence of cognitive impairment as measured by a comprehensive battery of neuropsychological tests. The lack of cognitive impairment is reassuring and suggests that self-reported symptoms of cognitive dysfunction are more likely related to the systemic and psychiatric side effects of antiviral treatment rather than measurable changes in cognition.

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Section: Discussionmentioning

confidence: 99%

Section: Cognitive Functionmentioning

confidence: 99%

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Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C†‡

et al. 2007

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“…43 Cognitive impairment is common in patients with CHC and advanced fibrosis. In an analysis of 201 patients enrolled in the Hepatitis C Long-term Treatment against Cirrhosis (HALT-C) trial, Fontana et al 44 found that 33% met the criteria for mild cognitive impairment, based on a battery of 10 cognitive tests. These deficits were most notable in the domains of verbal recall and working memory.…”

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confidence: 99%

The effects of HCV infection and management on health-related quality of life

2007

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“…30 Decreased verbal fluency and psychomotor retardation are also characteristic in this group of patients. 16,31 In standard neuropsychological tests, individuals with HCV exhibit deficits of mental and motor speed, divisibility and sustainability of attention and short-term working memory, but not intelligence quotient (IQ) or episodic memory.…”

Section: Neurocognitive Dysfunctionsmentioning

confidence: 76%

The neuropsychiatric aspect of the HCV infection

Więdłocha¹,

Marcinowicz²,

Sokalla³

et al. 2017

Adv Clin Exp Med

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HCV infection is significantly more prevalent in the population of psychiatric patients, drug addicts and people tending to undertake risky sexual behaviors than in the general population. This article presents a spectrum of psychopathological symptoms and psychological dysfunctions, an outline of current theories on the neuropathology and psychiatric aspects of HCV infection treatment. The unspecific character of the psychopathological symptoms in the HCV infection makes the process of thorough diagnostics and adequate treatment difficult, thus the specific and characteristic features have been emphasized. The aim of this review is to shed light not only on the basic information concerning CNS pathology but also on the conclusions emerging from the studies of different authors, of various methodology, in diverse study groups and also to investigate current topics of research. The results of neuroimaging studies have been presented as well. Attention has also been dedicated separately to specific issues, like psychiatric aspects of co-infection with HCV and HIV viruses, the chronic fatigue in the course of HCV infection, the influence of substance use disorders and difficulties encountered during treatment with interferon. Undiagnosed psychiatric disorders, not only inevitably decrease the already rather low quality of life but also cause non-adherence with recommendations and medications regimes, contributing to a worse treatment outcome. Finally, the above disorders, when left untreated, result in higher rates of risk-taking behaviors among the infected, thus imposing a danger not only to patients themselves but also to the healthy population.

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Cognitive function in hepatitis C patients with advanced fibrosis enrolled in the HALT-C trial

Cited by 76 publications

References 47 publications

Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C†‡

Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C†‡

The effects of HCV infection and management on health-related quality of life

The neuropsychiatric aspect of the HCV infection

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