Journal of the International Neuropsychological Society



Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C


ROBIN C.  HILSABECK  a1 a2 a3 c1, TAREK I.  HASSANEIN  a2, MEGHAN D.  CARLSON  a2, ELIZABETH A.  ZIEGLER  a2 and WILLIAM  PERRY  a1 a3
a1 Department of Neuropsychiatry & Behavioral Science, Texas Tech University Health Sciences Center, Lubbock, Texas
a2 Department of Medicine, Division of Hepatology, University of California, San Diego, California
a3 Department of Psychiatry, University of California, San Diego, California

Abstract

Hepatitis C virus (HCV) infection is a major public-health-care problem, with over 170 million infected worldwide. Patients with chronic HCV infection often complain of various cognitive problems as well as symptoms of depression, anxiety, and fatigue. Relatively little is known, however, about the specific cognitive deficits that are common among HCV patients, and the influence of psychiatric symptomatology on cognitive functioning. In the current study of 21 chronically infected HCV patients, we assessed subjective cognitive dysfunction, depression, anxiety, and fatigue and compared these symptom areas to cognitive tests assessing visuoconstruction, learning, memory, visual attention, psychomotor speed, and mental flexibility. Results revealed that cognitive impairment ranged from 9% of patients on a visuoconstruction task to 38% of patients on a measure of complex attention, visual scanning and tracking, and psychomotor speed, and greater HCV disease severity as indicated by liver fibrosis was associated with greater cognitive dysfunction. Objective cognitive impairment was not related to subjective cognitive complaints or psychiatric symptomatology. These findings suggest that a significant portion of patients with chronic HCV experience cognitive difficulties that may interfere with activities of daily living and quality of life. Future research using cognitive measures with HCV-infected patients may assist researchers in identifying if there is a direct effect of HCV infection on the brain and which patients may be more likely to progress to cirrhosis and hepatic encephalopathy. (JINS, 2003, 9, 847–854.)

(Received May 6 2002)
(Revised November 5 2002)
(Accepted November 5 2002)


Key Words: Neuropsychological impairment; Depression; Fatigue; HIV.

Correspondence:
c1 Reprint requests to: Robin C. Hilsabeck, Ph.D., Department of Neuropsychiatry & Behavioral Science, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 8321, Lubbock, TX 79430. E-mail: Robin.Hilsabeck@ttuhsc.edu


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