Cognitive impairment in patients with chronic hepatitis treated with interferon alpha (IFNalpha): results from a prospective study.
BACKGROUND
Treatment with low-dose interferon alpha (IFN-alpha) is often associated with neuropsychiatric side effects. In addition to depression and anxiety, IFN-alpha associated cognitive impairment significantly affects patient's mental health and quality of life.


OBJECTIVE
To measure possible effects of low-dose IFN-alpha on cognitive functioning and its relationship to the development of depression and anxiety.


METHODS
We prospectively followed 38 patients with a chronic hepatitis B or C by neuropsychological tests and psychiatric self-rating scales during 12 weeks of low-dose treatment with IFN-alpha.


RESULTS
Before IFN-alpha treatment, neuropsychological tests as well as self-ratings in the Beck's Depression Inventory (BDI), the Hospital Anxiety and Depression Scale (HADS) and the Self-Report Symptom Inventory 90 Items-Revised (SCL-90-R) were within the normal range. Following 12 weeks of treatment with IFN-alpha resulted in a slight, but significant increase in depression scores. Neuropsychological assessment after 12 weeks of IFN-alpha treatment showed a significant decrease of the immediate recall in the Auditory-Verbal Learning Test (AVLT) and a significant reduction of words recited in the Controlled Oral Word Association Test (COWA). Cognitive impairment did not significantly correlate with depressive symptoms or anxiety.


CONCLUSIONS
Our results indicate that even low-dose IFN-alpha induces cognitive impairment independent from depressive symptoms, which might be related to functional disturbances in the prefrontal cortex and the hippocampus. We suggest close monitoring of cognitive function during IFN-alpha treatment of chronic hepatitis.
Lieb
Klaus
K
Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Hauptstr. 5, 79104 Freiburg, Germany.
Engelbrecht
Marc A
MA
Gut
Oliver
O
Fiebich
Bernd L
BL
Bauer
Joachim
J
Janssen
Gesa
G
Schaefer
Martin
M
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000998:Antiviral Agents / Q000009:adverse effects*; D001008:Anxiety Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis; D003866:Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006521:Hepatitis, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012647:Self-Assessment
D000998:Antiviral Agents; D016898:Interferon-alpha