Journal of the International Neuropsychological Society

Research Articles

The cognitive effects of hepatitis C in the presence and absence of a history of substance use disorder

MARILYN HUCKANSa1a2a3 c1, ADRIANA SEELYEa1a4, TIFFANY PARCELa1a4, LISA MULLa1a4, JONATHAN WOODHOUSEa1a5, DANELL BJORNSONa1a6, BRET E. FULLERa1a2, JENNIFER M. LOFTISa1a2a3a7, BENJAMIN J. MORASCOa1a2, ANNA W. SASAKIa1a8, DANIEL STORZBACHa2 and PETER HAUSERa1a2a3a7a8a9

a1 Northwest Hepatitis C Resource Center, Portland VA Medical Center, Portland, Oregon

a2 Behavioral Health & Clinical Neurosciences Division, Portland VA Medical Center, Portland, Oregon

a3 Department of Psychiatry, Oregon Health and Science University, Portland, Oregon

a4 Department of Psychology, Pacific University, Portland, Oregon

a5 Department of Psychology, George Fox University, Portland, Oregon

a6 School of Nursing, Oregon Health and Science University, Portland, Oregon

a7 The JENS Lab, Portland VA Medical Center, Portland, Oregon

a8 Department of Internal Medicine, Oregon Health and Science University, Portland, Oregon

a9 Department of Behavioral Neurosciences, Oregon Health and Science University, Portland, Oregon

Abstract

The aim of the study was to determine whether infection with the hepatitis C virus (HCV) is associated with cognitive impairment beyond the effects of prevalent comorbidities and a history of substance use disorder (SUD). Adult veterans were recruited from the Portland Veterans Affairs Medical Center into three groups: (1) HCV+/SUD+ (n = 39), (2) HCV+/SUD− (n = 24), and (3) HCV−/SUD− (n = 56). SUD+ participants were in remission for ≥90 days, while SUD− participants had no history of SUD. Groups did not significantly differ in terms of rates of psychiatric or medical comorbidities. Procedures included clinical interviews, medical record reviews, and neuropsychological testing. Significant group differences were found in the domains of Verbal Memory, Auditory Attention, Speeded Visual Information Processing, and Reasoning/Mental Flexibility (p ≤ .05). Post hoc comparisons indicated that HCV+/SUD− patients performed significantly worse than HCV−/SUD− controls on tests measuring verbal learning, auditory attention, and reasoning/mental flexibility, but only HCV+/SUD+ patients did worse than HCV−/SUD− controls on tests of speeded visual information processing. Results indicate that chronic HCV is associated with cognitive impairment in the absence of a history of SUD. The most robust deficits appear to be in verbal learning and reasoning/mental flexibility. (JINS, 2009, 15, 69–82.)

(Received May 28 2008)

(Reviewed September 11 2008)

(Accepted September 15 2008)

Correspondence:

c1 Correspondence and reprint requests to: Marilyn Huckans, Portland VA Medical Center (P3MHDC), 3710 SW US Veteran’s Hospital Road, Portland, OR 97239. E-mail: marilyn.huckans@va.gov