Cognitive dysfunctions in patients with chronic hepatitis C

Background: Both presence and replication activity of the hepatitis C virus in brains of patients with chronic hepatitis C (CHC) were revealed. A significant proportion of CHC patients demonstrate cognitive abnormalities. The purpose of this exploratory study was an assessment of the specificity and frequency of cognitive dysfunctions and also clinical and demographical factors associated with cognitive deficits in CHC patients.
Material and methods: Adult CHC patients with compensated liver function, without current or past psychotic disorder, bipolar disorder, substance abuse or an organic brain damage were enrolled. Demographic and clinical data were collected from CHC patients and from control healthy subjects. Brief neuropsychological battery consisted of the TMT A+B and the Stroop Test A+B. Neuropsychological performance was compared within age subgroups (18-29, 30-39, 40-49 and 50-60 years). The cut-off point of >2 standard deviations (SD) was used for qualifying a result as markedly worse than that of healthy control subjects.
Results: 239 CHC patients aged 18-60 years and 170 healthy subjects adjusted for age and education level were recruited. Patients performed significantly worse on all cognitive measures in every age subgroup. Between 21% and 34% of CHC patients, depending on the measure, had substantial (>2 SD) cognitive dysfunctions. No correlation was found between cognitive performance and either staging or grading in liver biopsy in CHC patients.
Conclusions: Significant abnormalities of working memory and executive functions were present in at least 20% of CHC patients with compensated liver function within all age clusters. This may influence psychosocial functioning of the patients.