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Influence of hepatitis C virus on neurocognitive function in patients free from other risk factors: validation from therapeutic outcomes
Author(s) -
Pattullo Venessa,
McAndrews Mary Pat,
Damyanovich Andrei,
Heathcote E. Jenny
Publication year - 2011
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02549.x
Subject(s) - neurocognitive , medicine , hepatitis c virus , cohort , gastroenterology , quality of life (healthcare) , hepatitis c , immunology , virus , psychiatry , cognition , nursing
Background and Aims: Mild neurocognitive dysfunction and altered cerebral proton magnetic resonance spectroscopy ( 1 H‐MRS) have been demonstrated in patients with chronic hepatitis C (CHC). This longitudinal study aimed to quantify these abnormalities in a cohort of patients free from correlated risk factors and determine whether treatment‐induced viral clearance abolished these abnormalities. Methods: Treatment‐naïve, non‐cirrhotic patients with CHC, rigorously screened and excluded for other causes of impaired neurocognition, underwent neurocognitive testing, 1 H‐MRS and evaluation for quality of life (QOL), mood and fatigue, before and 6 months after the completion of antiviral therapy. A comparison group of healthy controls was similarly assessed at baseline and 1 year later. Results: Post‐treatment results in 40 patients with CHC [31 sustained virological responders, hepatitis C virus (HCV)‐R and 9 non‐responders, HCV‐NR] were compared with their pretreatment results, and with the baseline and follow‐up assessments of 39 healthy controls. Before receiving treatment, patients had impaired learning efficiency, poorer QOL and higher fatigue scores compared with the controls. Viral clearance was associated with a significant albeit small improvement in the QOL score that did not reach control levels. Cerebral 1 H‐MRS demonstrated a lower N ‐acetyl aspartate/creatine (CRE) ratio in the globus pallidus (GP) of patients with hepatitis C, which was unchanged with viral clearance. The GP choline/CRE ratio increased in HCV‐R following treatment, without a correlation with cognitive measures. Conclusions: The hepatitis C virus has a measurable effect on CNS integrity in patients screened for other medical and/or psychiatric comorbidities. Viral clearance has not been demonstrated to abolish these abnormalities.