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Cytokines influence impaired cognitive function in children with HCV

Researchers in Egypt found a significant correlation between various endogenous cytokines and cognitive impairment among a cohort of Egyptian children with hepatitis C virus infection, according to published findings.

“Chronic HCV infection may cause many extrahepatic manifestations, one of which affects the central nervous system,” the researchers wrote. “About one-third of patients with chronic HCV infection with compensated cirrhosis have cognitive dysfunction. … Little is known about how HCV infection affects cognitive function in children, so studies to assess the impact of HCV infection on cognitive function in children are needed.”

In this case-control study, researchers analyzed data of 35 children with HCV after age- and sex-matching them with 23 healthy controls. These patients were randomly recruited from an outpatient liver clinic at Assiut University Children’s Hospita, and all had normal liver function tests, which included no evidence of cirrhosis or liver cell failure. Researchers sought to assess the impact of HCV infection on cognitive function of children and their relationships to endogenous interferon-alfa (IFN-a), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). They measured these cytokines using the Arabic version of the Stanford–Binet test.

“It is hypothesized that higher levels of these endogenous cytokines would be associated with poorer performances in cognitive measures,” the researchers wrote.

Overall, serum levels of IL-6 and IFN-a were higher in patients compared with controls. However, no difference in serum level of TNF-alpha was observed between groups.

There were significant effects on vocabulary, comprehension, abstract visual reasoning test, quantitative reasoning test, bead memory test, total short-term memory and intelligence quotient in patients compared with the controls.

Higher levels of IFN-a were correlated with greater levels of IL-6 (P = .000), but not TNF-alpha.

IFN-a was negatively correlated when testing for abstract visual reasoning (P = .026), quantitative reasoning (P = .037), bead memory (P = .039), total short-term memory (P = .025) and intelligence quotient (P = .007).

IL-6 also was negatively correlated with abstract visual reasoning (P = .002), quantitative reasoning (P = .000) and intelligence quotient (P = .008) tests.

TNF-alpha was not associated with any of the cognitive functions, according to the research.

“Children with HCV infection in its early stages showed signs of cognitive impairments, and the memory tasks are the most affected,” the researchers concluded. “There is a significant relationship between endogenous cytokines and cognitive function in children with HCV infection. Further studies will need to define the effect of successful antiviral treatment on cognitive function in these children.” – by Melinda Stevens

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