Hepatitis C virus infection and neurocognitive function

Soogoor, Malini; Lynn, Henry; Donfield, Sharyne; Gomperts, Edward D.; Bell, Terece S.; Daar, Eric S.

doi:10.1212/01.wnl.0000240255.42608.99

Cited by 31 publications

(25 citation statements)

References 11 publications

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“…In this group, the time lag between infection and cognitive assessment might have been significantly lower compared to the other, adult cohorts, thus possibly explaining, at least to some extent, the negative results [27] . One study that compared cognitive performance in 32 patients with chronic hepatitis C against 29 chronic hepatitis B showed than HCV patients had worse performance in verbal learning and memory compared to controls, but they did not differ from patients with hepatitis B virus liver disease [28] .…”

Section: Cognitive Alterations In Patients With Hcv Liver Diseasementioning

confidence: 77%

Neuropsychological alterations in hepatitis C infection: The role of inflammation

Senzolo¹

2011

WJG

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About 50% of patients with hepatitis C virus (HCV) infection complain of neuropsychiatric symptoms, "brain fog", weakness, fatigue, and exhibit some degree of quality of life impairment, irrespective of the severity of liver disease. Since the first observation of HCV-related cognitive deficits, 10 studies have been published that have evaluated neuropsychiatric performance in patients with HCV infection and different degrees of hepatic impairment�� Unfortunately, these have often included patients with cirrhosis, patients who had acquired the infection through previous intravenous drug misuse, who had a history of relatively recent treatment with interferon, or were on psychoactive medication�� In addition, different neuropsychological batteries and tests that explored different cognitive domains were used, which makes the results of the studies difficult to compare�� Finally, limited information is available on the pathogenesis of HCV-related cognitive impairment�� Cerebral and/or systemic inflammation may be important players but their potential role has not been substantiated by experimental data�� The present review outlines the available evidence of the presence of cognitive impairment in patients with HCV infection, with a focus on the potential relationship with cerebral and/or systemic inflammation.

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Section: Cognitive Alterations In Patients With Hcv Liver Diseasementioning

confidence: 77%

Neuropsychological alterations in hepatitis C infection: The role of inflammation

Senzolo¹

2011

WJG

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“…In all these studies, nervous system function has been correlated with the presence or absence of HCV indicators or load in peripheral blood. However, in contrast to these studies, there are investigators who have been unable to demonstrate HCV-specific deficits that go beyond the cognitive perturbations accompanying hepatic decompensation (Edwin et al, 1999;Hilsabeck et al, 2002;Soogoor et al, 2006). This has left unresolved an important question: are the cognitive abnormalities detected in these patients specific to HCV in the nervous system, or a function of systemic disease and/or impairments in hepatic function?…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic correlates of hepatitis C virus in brain: A pilot study

et al. 2008

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Hepatitis C virus (HCV) has been detected in the brain tissues of 10 individuals reported to date; it is unclear what clinical factors are associated with this, and with what frequency it occurs. Accordingly, a pilot analysis utilizing reverse transcriptase-polymerase chain reaction (RT-PCR) to detect and sequence HCV in premortem plasma and postmortem brain and liver from 20 human immunodeficiency virus (HIV)-infected and 10 HIV-naïve individuals was undertaken. RNA encoding the first 126 amino acids of the HCV E1 envelope protein and the majority of the E1 signal sequence was analyzed in parallel with an 80-base-long segment of the 5′ untranslated region (UTR). Liver HCV was detected only in subjects with premortem HCV viremia (10 HIV-infected and 3 HIVnaïve). Brain HCV was detected in 6/10 HCV/HIV-coinfected and 1/3 HCV-monoinfected subjects. In the setting of HIV, the magnitude of plasma HCV load did not correlate with the presence of brain HCV. However, coinfected patients with brain HCV were more often off antiretroviral therapy and tended to have higher plasma HIV loads than those with HCV restricted to liver. Furthermore, premortem cerebrospinal fluid (CSF) analysis revealed that HCV/HIV-coinfected patients with brain HCV had detectable CSF HIV, whereas those without brain HCV had undetectable CSF HIV loads (P = .0205). Neuropsychologic tests showed a trend for hierarchical impairment of abstraction/ executive functioning in HIV/HCV coinfection, with mean T scores for HIV monoinfected patients 43.2 (7.3), for liver-only HCV 39.5 (9.0), and for those with HCV in brain and liver 33.2 (5.1) (P = . 0927). Predominant brain HCV sequences did not match those of the plasma or liver in 4 of the 6 coinfected patients analyzed. We conclude that in the setting of HIV/HCV coinfection, brain HCV is a common phenomenon unrelated to the magnitude of HCV viremia, but related to active HIV disease and detectable CSF HIV. Furthermore, there is sequence evidence of brain compartmentalization. Differences in abstraction/executive function of HCV/HIV coinfected patients compared to HIV monoinfected warrant further studies to determine if neuropsychiatric effects are predicated upon brain infection.

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“…A rather large study in the Hemophilia Growth and Development Study reported that after controlling for multiple factors, HCV monoinfection was not associated with deficits in adaptive behavior, intelligence, or attention/concentration. 21 Still, several investigators have carefully studied substantial numbers of patients and concluded that HCV is associated with negative neurocognitive consequences. Letendre et al 22 concluded that HCV contributed to neuropsychological deficits observed in a study of HIV-infected and stimulant-dependent participants.…”

Section: Data Collection Other Factors Examined In Analysis Includementioning

confidence: 99%

Effects of Active HCV Replication on Neurologic Status in Hiv Rna Virally Suppressed Patients

Garvey¹,

Pflugrad²,

Thiyagarajan³

et al. 2010

Neurology

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Hepatitis C virus infection and neurocognitive function

Cited by 31 publications

References 11 publications

Neuropsychological alterations in hepatitis C infection: The role of inflammation

Neuropsychological alterations in hepatitis C infection: The role of inflammation

Clinicopathologic correlates of hepatitis C virus in brain: A pilot study

Effects of Active HCV Replication on Neurologic Status in Hiv Rna Virally Suppressed Patients

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