Neurocognitive changes in patients with hepatitis C receiving interferon alfa-2b and ribavirin.
BACKGROUND
During antiviral therapy of chronic hepatitis C, patients frequently report impairment of concentration or memory. Therefore we prospectively investigated neurocognitive performance in patients receiving interferon alfa and ribavirin.


METHODS
Repeated computer-based testing of neurocognitive function was performed in 70 patients with chronic hepatitis C receiving interferon alfa-2b (pegylated or conventional) and ribavirin. In addition, depression scores were obtained (Hospital Anxiety and Depression Scale).


RESULTS
Reaction times were significantly increased during treatment (mean reaction time increase after 3 months of therapy: alertness, 46.76 ms [95% confidence interval (CI)], 26.86-66.66 ms), P < .001; divided attention, 47.04 ms [95% CI, 26.44-67.64 ms], P < .001; vigilance, 60.78 ms [95% CI, 29.24-92.32 ms], P < .001; and working memory, 38.53 ms [95% CI, 1.22-75.83], P = .34). Accuracy measures (number of false reactions) were affected for the working-memory task exclusively. Cognitive performance returned to pretreatment values after the end of therapy. Cognitive impairment was not significantly correlated with the degree of concomitant depression (0.04 < r [absolute value] < 0.10, P > .390).


CONCLUSIONS
Interferon-based combination therapy of chronic hepatitis C causes significant but reversible impairment of neurocognitive performance. Consequences for the requirements of an active life in patients with chronic hepatitis C receiving antiviral therapy need to be assessed.
Kraus
Michael R
MR
Department of Gastroenterology and hepatology, Medizinische Poliklinik, University of Würzburg, D-97070 Würzburg, Germany. kraus_m@klinik.uni-wuerzburg.de
Schäfer
Arne
A
Wissmann
Saskia
S
Reimer
Peter
P
Scheurlen
Michael
M
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D019698:Hepatitis C, Chronic / Q000145:classification / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000139:chemically induced* / Q000175:diagnosis; D011597:Psychomotor Performance / Q000187:drug effects; D011930:Reaction Time / Q000187:drug effects; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin