Cognitive function in hepatitis C patients with advanced fibrosis enrolled in the HALT-C trial.
OBJECTIVE
Prior studies have demonstrated neuropsychological abnormalities in chronic hepatitis C (CHC) patients even with mild fibrosis. The aim of this study was to determine the frequency, type, and severity of cognitive impairment in a large group of CHC patients with advanced fibrosis.


METHODS
Ten validated neuropsychological tests were administered to 201 CHC patients. Standard scores for individual tests were calculated using normative population data that controlled for age, gender, and/or education. Lifetime psychiatric history, alcohol consumption, and mood status were also determined.


RESULTS
33% of patients met criteria for cognitive impairment (i.e. standard score <40 on at least 4 tests). Mild impairment in verbal recall and working memory were noted with other domains remaining intact. Liver disease severity and lifetime psychiatric/substance abuse history did not correlate with group mean cognitive test results or the presence of cognitive impairment. In contrast, IQ and depression scores were significant and independent predictors of cognitive impairment (ROC = 0.84).


CONCLUSIONS
33% of patients entering the HALT-C trial have evidence of a mild, non-focal subcortical processing deficit which was highly correlated with IQ, education, and occupation. Future studies of cognitive function in CHC patients should control for general cognitive ability.
Fontana
Robert J
RJ
Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109-0362, USA. rfontana@umich.edu <rfontana@umich.edu>
Bieliauskas
Linas A
LA
Back-Madruga
Carla
C
Lindsay
Karen L
KL
Kronfol
Ziad
Z
Lok
Anna S
AS
Padmanabhan
Latha
L
D000339:Affect; D000428:Alcohol Drinking / Q000453:epidemiology; D001288:Attention; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology*; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000523:psychology*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011930:Reaction Time; D012959:Socioeconomic Factors; D013060:Speech