Subclinical impairment of brain function in chronic hepatitis C infection.
OBJECTIVE
Central nervous system abnormalities such as fatigue and depression occur more frequently in chronic hepatitis C virus (HCV) infection than in many other causes of chronic liver disease. The finding that fatigue is unrelated to activity of hepatitis or mode of infection could indicate an independent effect of HCV on brain function. This study tested the hypothesis of a subclinical cognitive dysfunction in HCV-infected patients.


METHODS
One-hundred untreated HCV-RNA positive biopsy-proven patients were investigated by P300 event-related potentials, a sensitive electrophysiologic test of cognitive processing. Health-related quality of life and fatigue were assessed using the SF-36 questionnaire and the Fatigue Impact Scale, respectively.


RESULTS
Cognitive brain function was subclinically impaired in the cohort of HCV-infected patients as indicated by significantly prolonged P300 latencies (P=0.01 for comparison to matched healthy subjects) and reduced P300 amplitudes (P<0.001, respectively). Seventeen of the 100 HCV-infected patients had P300 latencies outside the age-adjusted normal range. Abnormal P300 characteristics were not related to the degree of histologic or biochemical activity of hepatitis, severity of fatigue or mental health impairment.


CONCLUSIONS
This study demonstrates that patients with HCV infection showed a slight but significant neurocognitive impairment, possibly indicating a further extrahepatic manifestation of chronic hepatitis C.
Kramer
Ludwig
L
Department of Medicine IV, University Hospital Vienna, Währinger Gürtel 18-20, Vienna, Austria. ludwig.kramer@akh-wien.ac.at
Bauer
Edith
E
Funk
Georg
G
Hofer
Harald
H
Jessner
Wolfgang
W
Steindl-Munda
Petra
P
Wrba
Friedrich
F
Madl
Christian
C
Gangl
Alfred
A
Ferenci
Peter
P
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000821:virology; D001927:Brain Diseases / Q000503:physiopathology / Q000821:virology*; D003072:Cognition Disorders / Q000503:physiopathology / Q000821:virology*; D018913:Event-Related Potentials, P300; D005221:Fatigue / Q000821:virology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000821:virology