title: Greater decline in memory and global neurocognitive function in HIV/hepatitis C co-infected than in hepatitis C mono-infected patients treated with pegylated interferon and ribavirin.
abstract: The human immunodeficiency virus (HIV), hepatitis C virus (HCV), and the treatment of HCV with pegylated interferon and ribavirin (IFN/RBV) have been associated with neurocognitive and psychiatric abnormalities. The goal of this research was to prospectively evaluate neurocognitive functioning among a group of HCV mono-infected and HIV/HCV co-infected patients during the first 24 weeks of IFN/RBV treatment while accounting for practice effects, normal variations in change over time, and variations in IFN/RBV treatment exposure. Forty-four HCV mono-infected and 30 HIV/HCV co-infected patients were enrolled in a prospective study of patients beginning on IFN/RBV for chronic HCV infection. Patients were administered a depression inventory, a measure of fatigue, a structured psychiatric interview, and a neurocognitive battery at baseline and 24 weeks after initiation of treatment. Analyses were conducted to explore possible associations between neurocognitive functioning and the following: HIV/HCV co-infection vs. HCV mono-infection, IFN and RBV treatment exposure, psychiatric status, liver disease stage, and other medical characteristics. At baseline, there were no significant differences between the two groups' neuropsychiatric or neurocognitive function other than the mono-infected group had significantly higher reports of fatigue (p = 0.033). Over the course of 24 weeks of treatment after controlling for practice effects, the HIV/HCV co-infected patients experienced significantly greater declines in memory (t(56) = 2.14, p = 0.037) and global neurocognitive functioning (t(53) = 2.28, p = 0.027). In a well-characterized sample of mono-infected and co-infected patients, it appears that persons with HIV/HCV co-infection are potentially more vulnerable to neurocognitive sequalae during HCV treatment.
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1087, New York, NY, 10029, USA.|Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.
authors.forename: Theodore R
authors.initials: TR
authors.lastname: Miller
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1087, New York, NY, 10029, USA. Jeffrey.Weiss@mountsinai.org.|Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA. Jeffrey.Weiss@mountsinai.org.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Weiss
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1087, New York, NY, 10029, USA.|Infectious Disease Section, Bronx Veterans Affairs Medical Center, 130 W. Kingsbridge Road, Bronx, New York, NY, 10468, USA.
authors.forename: Norbert
authors.initials: N
authors.lastname: Bräu
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1087, New York, NY, 10029, USA.
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Dieterich
authors.affiliation: Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, PO Box 1087, New York, NY, 10029, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Stivala
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.|Psychology Department, Fordham University, DE 340, 441 E. Fordham Road, Bronx, NY, 10458, USA.|Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Rivera-Mindt
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D060825:Cognitive Dysfunction / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D060085:Coinfection; D004359:Drug Therapy, Combination; D005260:Female; D006678:HIV / Q000472:pathogenicity / Q000502:physiology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects / Q000472:pathogenicity / Q000502:physiology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a
keywords: HIV; Hepatitis C; Neurocognitive; Pegylated interferon; Ribavirin; Side effects