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Neuropsychological test performance in patients co-infected with hepatitis C virus and HIV
William Perry1, Meghan D Carlson, Fatma Barakat
1Hepatology Neurobehavioral Research Program, University of California, San Diego, CA 92103-8218, USA. wperry@ucsd.edu
Insights
Hepatitis C virus (HCV) patients, with or without HIV co-infection, show similar attention, concentration, and psychomotor speed deficits. Greater liver fibrosis correlated with poorer neuropsychological performance in both groups.
Area of Science:
- Neuroscience
- Hepatology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection can affect cognitive function.
- The impact of Human Immunodeficiency Virus (HIV) co-infection on the central nervous system in HCV patients is not fully understood.
- Assessing neuropsychological performance is crucial for understanding the burden of viral infections on cognitive health.
Purpose of the Study:
- To compare neuropsychological performance between patients with HCV alone and those co-infected with HCV and HIV.
- To investigate the effect of co-infection on cognitive deficits in attention, concentration, and psychomotor speed.
- To determine the relationship between liver disease severity (fibrosis stage) and cognitive function in these patient groups.
Main Methods:
- A neuropsychological screening battery was administered to 47 HCV-alone and 29 HCV/HIV-co-infected patients.
- Patient performance was compared to normative data and between the two study groups.
- Liver fibrosis was staged using the METAVIR system, and its correlation with neuropsychological test results was analyzed.
Main Results:
- HCV patients, regardless of HIV co-infection status, exhibited deficits in attention, concentration, and psychomotor speed.
- No significant differences in neuropsychological performance were observed between HCV-alone and HCV/HIV-co-infected patients.
- A significant relationship was found between the stage of liver fibrosis and neuropsychological test performance, with greater fibrosis associated with poorer outcomes.
Conclusions:
- Relatively healthy patients with HCV, whether mono-infected or co-infected with HIV, may experience cognitive deficits in attention, concentration, and psychomotor speed.
- HIV co-infection did not lead to significantly different neuropsychological deficits compared to HCV-alone infection in this cohort.
- Liver fibrosis severity is a key factor associated with impaired cognitive function in patients with chronic HCV infection.
Objective:
To determine the effect of co-infection on neuropsychological performance in relatively healthy hepatitis C virus (HCV)-alone patients when compared with HCV/HIV-co-infected patients.
Design:
To test whether the burden of co-infection with HCV and HIV on the central nervous system results in increased cognitive deficits, we tested 47 HCV-alone and 29 HCV/HIV-co-infected patients on a neuropsychological screening battery of tests of attention, concentration and psychomotor speed.
Methods:
The neuropsychological test performance of HCV-alone and HCV/HIV-co-infected patients was compared with normative samples. The test performance between HCV-alone and HCV/HIV-co-infected patients was also assessed. Patients with chronic liver disease were divided on the basis of disease severity as determined by fibrosis stage, according to the METAVIR system. Neuropsychological test performance was correlated with fibrosis stage.
Results:
As previously reported, HCV patients independent of co-infection status demonstrated deficits on neuropsychological measures of attention, concentration and psychomotor speed. No significant differences were found between patients with HCV-alone and HCV/HIV-co-infected patients on the neuropsychological measures. There was a relationship between neuropsychological test performance and fibrosis stage.
Conclusion:
Relatively healthy patients with HCV (either alone or when co-infected with HIV) may have deficits in the domains of attention, concentration and psychomotor speed. In this study no significant differences were found between patients with HCV alone and HCV/HIV-co-infected patients on neuropsychological measures, but as previously demonstrated, greater fibrosis was associated with poorer performance.
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