title: Cognitive function in hepatitis C patients with advanced fibrosis enrolled in the HALT-C trial.
abstract: 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.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109-0362, USA. rfontana@umich.edu <rfontana@umich.edu>
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fontana
authors.forename: Linas A
authors.initials: LA
authors.lastname: Bieliauskas
authors.forename: Carla
authors.initials: C
authors.lastname: Back-Madruga
authors.forename: Karen L
authors.initials: KL
authors.lastname: Lindsay
authors.forename: Ziad
authors.initials: Z
authors.lastname: Kronfol
authors.forename: Anna S
authors.initials: AS
authors.lastname: Lok
authors.forename: Latha
authors.initials: L
authors.lastname: Padmanabhan
mesh_terms: 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