Hepatitis C and cognitive impairment in a cohort of patients with mild
liver disease.

Forton DM, Thomas HC, Murphy CA, Allsop JM, Foster GR, Main J, Wesnes
KA,
Taylor-Robinson SD.

Hepatology Section, Division of Medicine A, Faculty of Medicine,
Imperial
College, St Mary's Hospital, London, UK. d.forton@...

Patients with chronic hepatitis C virus (HCV) infection frequently
report
fatigue, lassitude, depression, and a perceived inability to function
effectively. Several studies have shown that patients exhibit low
quality-of-life scores that are independent of disease severity. We
therefore considered whether HCV infection has a direct effect on the
central nervous system, resulting in cognitive and cerebral metabolite
abnormalities.

Twenty-seven viremic patients with biopsy-proven mild hepatitis due to
HCV
and 16 patients with cleared HCV were tested with a computer-based
cognitive assessment battery and also completed depression, fatigue,
and
quality-of-life questionnaires. The HCV-infected patients were impaired
on
more cognitive tasks than the HCV-cleared group (mean [SD]:
HCV-infected,
2.15 [1.56]; HCV-cleared, 1.06 [1.24]; P =.02).

A factor analysis showed impairments in power of concentration and
speed of
working memory, independent of a history of intravenous drug usage
(IVDU),
depression, fatigue, or symptom severity.

A subgroup of 17 HCV-infected patients also underwent cerebral proton
magnetic resonance spectroscopy (1H MRS). The choline/creatine ratio
was
elevated in the basal ganglia and white matter in this group. Patients
who
were impaired on 2 or more tasks in the battery had a higher mean
choline/creatine ratio compared with the unimpaired patients.

In conclusion, these preliminary results demonstrate cognitive
impairment
that is unaccounted for by depression, fatigue, or a history of IVDU in
patients with histologically mild HCV infection. The findings on MRS
suggest that a biological cause underlies this abnormality.

PMID: 11826420 [PubMed - indexed for MEDLINE]

Source URL:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra\
ct&list_uids=11826420







Sandra Tara Balduf (Ane)

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