J Viral Hepat. 2017
Persistent neuropsychiatric impairment in HCV patients despite clearance of the virus?!
Meike Dirks, Henning Pflugrad, Kim Haag, Hans L. Tillmann, Heiner Wedemeyer, Dimitrios Arvanitis, Hartmut Hecker, Argyro Tountopoulou, Annemarie Goldbecker, Hans Worthmann, Karin Weissenborn
Accepted manuscript online: 24 January 2017
DOI: 10.1111/jvh.12674
Abstract
Background
One of the most disabling symptoms of hepatitis C virus (HCV)-infection is chronic fatigue. While this is accepted for HCV-polymerase chain reaction (PCR)-positive patients a relationship between HCV-infection and chronic fatigue is questioned after successful virus eradication.
Aims
As fatigue is a subjective criterion we aimed to evaluate in addition mood alterations and cognitive function in HCV-exposed patients with only mild liver disease and to assess a) possible interrelationships between these factors and health related quality of life, and b) the impact of viremia and former interferon treatment.
As fatigue is a subjective criterion we aimed to evaluate in addition mood alterations and cognitive function in HCV-exposed patients with only mild liver disease and to assess a) possible interrelationships between these factors and health related quality of life, and b) the impact of viremia and former interferon treatment.
Methods
159 anti-HCV-positive individuals without advanced liver disease answered health related quality of life (HRQoL), fatigue and depression questionnaires and underwent a battery of attention and memory tests. Accompanying diseases which could distort the results of the study such as HIV-co-infection or drug addiction were exclusion criteria. The patients were subdivided into four groups according to their viremia-status and interferon treatment history. Patients’ data were evaluated with respect to norms given in the respective test manuals and in addition compared to those of 33 age-matched healthy controls.
159 anti-HCV-positive individuals without advanced liver disease answered health related quality of life (HRQoL), fatigue and depression questionnaires and underwent a battery of attention and memory tests. Accompanying diseases which could distort the results of the study such as HIV-co-infection or drug addiction were exclusion criteria. The patients were subdivided into four groups according to their viremia-status and interferon treatment history. Patients’ data were evaluated with respect to norms given in the respective test manuals and in addition compared to those of 33 age-matched healthy controls.
Results
Eighty-five percent of the patients had chronic fatigue, 50-60% mild depression or anxiety, 45% memory deficits and 30% attention deficits, irrespective of their HCV-viremia-status or treatment history. HRQoL correlated negatively with chronic fatigue (p<0.001), while cognitive deficits – especially memory function were independent from fatigue and depression.
Eighty-five percent of the patients had chronic fatigue, 50-60% mild depression or anxiety, 45% memory deficits and 30% attention deficits, irrespective of their HCV-viremia-status or treatment history. HRQoL correlated negatively with chronic fatigue (p<0.001), while cognitive deficits – especially memory function were independent from fatigue and depression.
Conclusions
HCV-infection may cause long-standing cerebral dysfunction that significantly impairs HRQoL and may even persist after clearance of the virus.
This article is protected by copyright. All rights reserved.
HCV-infection may cause long-standing cerebral dysfunction that significantly impairs HRQoL and may even persist after clearance of the virus.
This article is protected by copyright. All rights reserved.
Of Interest
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