Cognition in hepatitis C patients treated with pegylated interferon.
Neuropsychiatric symptoms are frequently reported by patients with chronic hepatitis C during treatment with interferon (IFN)-alpha and may lead to treatment discontinuation. In order to assess the objective neuropsychiatric impairments we prospectively administered standardized neuropsychological testing before and 3 months after the initiation of antiviral treatment with pegylated IFN-alpha in 17 patients suffering from chronic hepatitis C. In addition depression and anxiety scores, social functioning and hepatological parameters were obtained. While depressive and anxiety symptoms increased significantly during treatment only subtle worsening in neurocognitive performance could be detected, indicating slight impairment in cognitive flexibility and psychomotor speed (Trail Making Test B; 69.6+/-23 s before vs. 80.7+/-31 s during therapy, P=0.011, not remaining significant after Bonferroni correction). We found no association between reduced neurocognitive performance and the severity of depression. Better neurocognitive performance in single domains was associated with better response to antiviral treatment measured as the decline of elevated liver enzymes (AST). We conclude that neurocognitive performance was influenced by antiviral IFN-alpha-based combination treatment only in single domains and not to a clinically relevant extent in contrast to the significant worsening of depression.
Wobrock
Thomas
T
Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Göttingen, Germany. twobroc@gwdg.de
Mihm
Ulrike
U
Löhr
Caroline
C
Hofmann
Wolf-Peter
WP
Sarrazin
Christoph
C
Zeuzem
Stefan
S
Falkai
Peter
P
D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011994:Recombinant Proteins; D012720:Severity of Illness Index
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a