Hepatitis C infection, Cognition, and inflammation in an Egyptian sample

Chronic hepatitis C (HCV) infection is associated with cognitive impairments which might be mediated through a secondary inflammatory cascade. Egypt has an unusually high prevalence of HCV monoinfections and is an ideal site for the study of the isolated effects of HCV infection. Therefore, in a hospital-based cross-sectional study based in Egypt, this study compared cognitive functioning and serum markers of inflammation in 11 HCV positive cases and 14 HCV negative controls. The Wisconsin Card Sorting Test was used to assess cognitive flexibility and the Brief Visuospatial Memory Test-Revised was used to assess learning and memory. Circulating levels of soluble tumor necrosis factor receptor II (sTNFR-II), monocyte chemotactic protein-1 (MCP-1/CCL2), and soluble CD14 (sCD14) were determined as indices of inflammation. HCV positive cases had higher levels of sTNFR-II (t = -3.5, P = 0.002). HCV positive cases also had significantly worse cognitive flexibility with higher number of total errors (t = -2.18, P = 0.04), and preservative responses (t = -2.12, P = 0.05), and lower number of conceptual level responses (t = 1.32, P = 0.04) on the Wisconsin Card Sorting test. In conclusion, results from this pilot study indicate that HCV+ patients have worse cognitive performance and somewhat greater inflammatory activity as compared to controls. The increased inflammation may be associated with the cognitive impairments observed in these HCV+ patients.