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Treatment response improved neurocognitive function in patients with chronic HCV

Patients with chronic HCV who responded to treatment with pegylated interferon and ribavirin experienced a subsequent improvement to neurocognitive performance in a recent study.

Using the Test for Attentional Performance (TAP), researchers evaluated the neurocognitive capabilities of 168 adult patients with hepatitis C before and after weekly treatment with peginterferon alfa-2b and weight-based ribavirin for 24 or 48 weeks. Participants took the computer-aided TAP test at baseline and 12 months or longer (range 12 to 48 months) after completing therapy.

Factors assessed by the TAP test included:

• Alertness: Evaluates reaction time via a task involving visual stimulus presented with and without acoustic cues.
• Divided attention: Assesses the ability to pay attention simultaneously to multiple aspects of visual or acoustic tasks.
• Vigilance: Measures sustained attention to acoustic and visual stimuli.
• Working memory: Evaluates a participant’s short-term memory.

Sustained virologic response (SVR) to treatment occurred in 69% of cases. Patients who experienced SVR indicated improved performance in three categories: vigilance, divided attention – optical task and working memory (P<.001 for all three). These participants also had better scores during post-treatment testing than those who did not respond to treatment in the vigilance (P=.004) and working memory (P=.01) categories; no significant difference was observed in pretreatment scores.

No significant improvement or deterioration in performance was seen for any categories among treatment nonresponders (P values between .194 and .804 for each subtask).

“Our data confirm previous reports that in patients with chronic HCV infection, neuropsychological performance is affected not only by high-dose interferon alfa-2b therapy, but also by the infection per se; furthermore, this latter impairment is potentially reversible after successful virus eradication,” the researchers concluded. “We suggest that the potential benefit of a successful therapy for chronic hepatitis C with respect to the patients’ neurocognitive function should be considered as an additional treatment indication in this disease.

“The aim of further studies would be to clarify the exact mechanisms that link HCV infection and neurocognitive function.”

Disclosure: See the study for a full list of relevant disclosures.