title: Improvement of neurocognitive function in responders to an antiviral therapy for chronic hepatitis C.
abstract: Earlier studies have suggested neurocognitive impairment in patients with chronic hepatitis C virus (HCV) infection even before liver cirrhosis has developed. Since these deficits might be reversible after successful antiviral therapy, we analyzed the long-term course of neurocognitive parameters in HCV patients with and without successful virus elimination by an interferon-based antiviral treatment. In a multicenter study including 168 HCV patients receiving antiviral therapy (peginterferon alpha-2b and ribavirin) we performed a long-term follow-up of neurocognitive performance before and after treatment. Neurocognitive function was psychometrically assessed using the computer-aided TAP (Test Battery of Attentional Performance). When tested at least 12 months after termination of antiviral treatment, patients with sustained virologic response (SVR) had improved significantly as compared to their pretreatment performance in three of five TAP subtasks (vigilance, P < 0.001; shared attention: optical task, P < 0.001; working memory, P < 0.001). Patients who failed to eradicate the virus, however, showed no significant long-term changes in neurocognitive performance in all five subtasks assessed (0.194 < P < 0.804). In the posttreatment evaluation, neurocognitive function was significantly better in responders to the antiviral therapy as compared to nonresponders.
  
  
  CONCLUSIONS
  Successful eradication of HCV leads to a significant improvement of relevant aspects of attentional and neurocognitive performance, indicating that the neurocognitive impairment caused by chronic HCV infection is potentially reversible. This therefore suggests an added therapeutic benefit of antiviral treatment in HCV infection. Improvement of neurocognitive function may be an additional treatment indication in patients with HCV. (HEPATOLOGY 2013;58:497-504).
authors.affiliation: Medizinische Klinik und Poliklinik II, Department of Gastroenterology, University of Würzburg, Würzburg, Germany.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kraus
authors.forename: Arne
authors.initials: A
authors.lastname: Schäfer
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Teuber
authors.forename: Heiner
authors.initials: H
authors.lastname: Porst
authors.forename: Kathrin
authors.initials: K
authors.lastname: Sprinzl
authors.forename: Sven
authors.initials: S
authors.lastname: Wollschläger
authors.forename: Christian
authors.initials: C
authors.lastname: Keicher
authors.forename: Michael
authors.initials: M
authors.lastname: Scheurlen
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects / Q000502:physiology; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011581:Psychological Tests; D011594:Psychometrics; D011994:Recombinant Proteins / Q000627:therapeutic use; D015203:Reproducibility of Results; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b