Neuropsychological effects of direct‐acting antiviral treatment for Hepatitis C virus subjects: A systematic review

Abstract

Chronic Hepatitis C is a disease related to the Hepatitis C virus (HCV), associated with adverse extrahepatic manifestations on the Central Nervous System, with neurological and neuropsychological effects, 1 induction of depression, fatigue, sleep disturbances 2-4 and worse health-related quality of life-HRQoL. 5 These neuropsychiatric and neurocognitive changes have been reported in cases of non-cirrhotic infection, 6 in minimal hepatic encephalopathy 7,8 and in more severe cases of hepatic encephalopathy.Interferon based-treatment (IFN) for HCV is related to a decrease of neuropsychological functions, such as executive function and attention, 9-11 as well as neuropsychiatric dysfunction involving depression, anxiety, fatigue and deterioration of HRQoL. 12,13

Patient‐centered and integrated outreach care for chronic hepatitis C patients with serious mental illness in Taiwan

“…28 Moreover, a systemic review has demonstrated the reversal of neurocognitive dysfunction after achieving an SVR. 29 We have also demonstrated…”

“…As one of the extrahepatic causes of CHC, HCV eradication has been associated with the improvement of quality of life 28 . Moreover, a systemic review has demonstrated the reversal of neurocognitive dysfunction after achieving an SVR 29 . We have also demonstrated that HCV eradication would reduce the risk of schizophrenia in a nationwide database from Taiwan 30 .…”

Improvement of chronic HCV infection‐related depression, anxiety, and neurocognitive performance in persons achieving SVR‐12: A real‐world cohort study

“…27 The studies that have explored cognitive function in PLHCV were extremely heterogeneous in terms of patient characteristics, confounding factors (e.g. intravenous drug use and alcohol intake), lack of control groups or standard cognitive testing methodology 10,[25][26][27] Despite being the largest prospective cohort till date, our study has few limitations. First, the number of women is only 23.9%, which may reflect on the gender differences in access to tertiary care in low-and middle-income countries like India.…”

“…The studies that have explored cognitive function in PLHCV were extremely heterogeneous in terms of patient characteristics, confounding factors (e.g. intravenous drug use and alcohol intake), lack of control groups or standard cognitive testing methodology 10,25–27 …”

“…8,9 The presence of depression and cognitive impairment may affect medication adherence in patients on antivirals, although HCV clearance has been demonstrated to improve cognition in a recent metaanalysis. 10 Cognitive impairment has been noted as subtle changes in processing speed or reaction times, memory, performance tests for vigilance, attention, psychomotor speed and verbal fluency in up to 50% of PLHCV. 11 The neurocognitive defects are independent of the presence of hepatic encephalopathy (HE) in patients with cirrhosis.…”