Interferon-free therapy in hepatitis C virus (HCV) monoinfected and HCV/HIV coinfected patients: Effect on cognitive function, fatigue, and mental health

Felix Kleefeld; Sophie Heller; Patrick Ingiliz; Heiko Jessen; Anders Petersen; Ute Kopp; Antje Kraft; Katrin Hahn

doi:10.1007/s13365-018-0647-z

Interferon-free therapy in hepatitis C virus (HCV) monoinfected and HCV/HIV coinfected patients: Effect on cognitive function, fatigue, and mental health

Felix Kleefeld, Sophie Heller, Patrick Ingiliz, Heiko Jessen, Anders Petersen, Ute Kopp, Antje Kraft, Katrin Hahn^*

^*Corresponding author for this work

17 Citations (Scopus)

Abstract

The efficacy and safety of interferon-free therapies for hepatitis C virus (HCV) infection have been reported. Considering the accumulating evidence for a direct central nervous system infection by HCV, we aim to evaluate the effect of direct acting antivirals (DAA) therapy on cognitive function in HCV patients. We conducted a longitudinal analysis of the cognitive performance of 22 patients (8 HCV+, 14 HCV+/HIV+) who completed neuropsychological testing at baseline and at week 12 after DAA therapy. In 20 patients, we analyzed specific attention parameters derived from an experimental testing based on the Theory of Visual Attention (TVA). Depression, fatigue, and mental health were assessed as patient reported outcomes. At baseline, 54.5% of the patients met the criteria for cognitive impairment and 40% showed impairment in TVA parameters. Follow-up analysis revealed significant improvements in the domains of visual memory/learning, executive functions, verbal fluency, processing speed, and motor skills but not in verbal learning and attention/working memory. We did not observe significant improvement in visual attention measured by TVA. Fatigue and mental health significantly improved at follow-up. Our findings indicate that successful DAA treatment leads to cognitive improvements in several domains measured by standard neuropsychological testing. The absence of improvement in TVA parameters and of significant improvement in the domain of attention/working memory might reflect the persistence of specific cognitive deficits after HCV eradication. In summary, DAA treatment seems to have a positive effect on some cognitive domains and leads to an improvement in mental health and fatigue in HCV-infected patients.

Original language	English
Journal	Journal of NeuroVirology
Volume	24
Issue number	5
Pages (from-to)	557-569
Number of pages	13
ISSN	1355-0284
DOIs	https://doi.org/10.1007/s13365-018-0647-z
Publication status	Published - 1 Oct 2018

Keywords

Clinical trial
Cognitive dysfunction
Direct acting antivirals
Hepatitis C virus
Neuropsychological assessment
Theory of Visual Attention

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s13365-018-0647-z

Cite this

Interferon-free therapy in hepatitis C virus (HCV) monoinfected and HCV/HIV coinfected patients : Effect on cognitive function, fatigue, and mental health. / Kleefeld, Felix; Heller, Sophie; Ingiliz, Patrick et al.

In: Journal of NeuroVirology, Vol. 24, No. 5, 01.10.2018, p. 557-569.

Research output: Contribution to journal › Journal article › Research › peer-review

@article{993b22fafb59400b96ed2b747905691a,

title = "Interferon-free therapy in hepatitis C virus (HCV) monoinfected and HCV/HIV coinfected patients: Effect on cognitive function, fatigue, and mental health",

abstract = "The efficacy and safety of interferon-free therapies for hepatitis C virus (HCV) infection have been reported. Considering the accumulating evidence for a direct central nervous system infection by HCV, we aim to evaluate the effect of direct acting antivirals (DAA) therapy on cognitive function in HCV patients. We conducted a longitudinal analysis of the cognitive performance of 22 patients (8 HCV+, 14 HCV+/HIV+) who completed neuropsychological testing at baseline and at week 12 after DAA therapy. In 20 patients, we analyzed specific attention parameters derived from an experimental testing based on the Theory of Visual Attention (TVA). Depression, fatigue, and mental health were assessed as patient reported outcomes. At baseline, 54.5% of the patients met the criteria for cognitive impairment and 40% showed impairment in TVA parameters. Follow-up analysis revealed significant improvements in the domains of visual memory/learning, executive functions, verbal fluency, processing speed, and motor skills but not in verbal learning and attention/working memory. We did not observe significant improvement in visual attention measured by TVA. Fatigue and mental health significantly improved at follow-up. Our findings indicate that successful DAA treatment leads to cognitive improvements in several domains measured by standard neuropsychological testing. The absence of improvement in TVA parameters and of significant improvement in the domain of attention/working memory might reflect the persistence of specific cognitive deficits after HCV eradication. In summary, DAA treatment seems to have a positive effect on some cognitive domains and leads to an improvement in mental health and fatigue in HCV-infected patients.",

keywords = "Clinical trial, Cognitive dysfunction, Direct acting antivirals, Hepatitis C virus, Neuropsychological assessment, Theory of Visual Attention",

author = "Felix Kleefeld and Sophie Heller and Patrick Ingiliz and Heiko Jessen and Anders Petersen and Ute Kopp and Antje Kraft and Katrin Hahn",

year = "2018",

month = oct,

day = "1",

doi = "10.1007/s13365-018-0647-z",

language = "English",

volume = "24",

pages = "557--569",

journal = "Journal of NeuroVirology",

issn = "1355-0284",

publisher = "Springer",

number = "5",

}

TY - JOUR

T1 - Interferon-free therapy in hepatitis C virus (HCV) monoinfected and HCV/HIV coinfected patients

T2 - Effect on cognitive function, fatigue, and mental health

AU - Kleefeld, Felix

AU - Heller, Sophie

AU - Ingiliz, Patrick

AU - Jessen, Heiko

AU - Petersen, Anders

AU - Kopp, Ute

AU - Kraft, Antje

AU - Hahn, Katrin

PY - 2018/10/1

Y1 - 2018/10/1

N2 - The efficacy and safety of interferon-free therapies for hepatitis C virus (HCV) infection have been reported. Considering the accumulating evidence for a direct central nervous system infection by HCV, we aim to evaluate the effect of direct acting antivirals (DAA) therapy on cognitive function in HCV patients. We conducted a longitudinal analysis of the cognitive performance of 22 patients (8 HCV+, 14 HCV+/HIV+) who completed neuropsychological testing at baseline and at week 12 after DAA therapy. In 20 patients, we analyzed specific attention parameters derived from an experimental testing based on the Theory of Visual Attention (TVA). Depression, fatigue, and mental health were assessed as patient reported outcomes. At baseline, 54.5% of the patients met the criteria for cognitive impairment and 40% showed impairment in TVA parameters. Follow-up analysis revealed significant improvements in the domains of visual memory/learning, executive functions, verbal fluency, processing speed, and motor skills but not in verbal learning and attention/working memory. We did not observe significant improvement in visual attention measured by TVA. Fatigue and mental health significantly improved at follow-up. Our findings indicate that successful DAA treatment leads to cognitive improvements in several domains measured by standard neuropsychological testing. The absence of improvement in TVA parameters and of significant improvement in the domain of attention/working memory might reflect the persistence of specific cognitive deficits after HCV eradication. In summary, DAA treatment seems to have a positive effect on some cognitive domains and leads to an improvement in mental health and fatigue in HCV-infected patients.

AB - The efficacy and safety of interferon-free therapies for hepatitis C virus (HCV) infection have been reported. Considering the accumulating evidence for a direct central nervous system infection by HCV, we aim to evaluate the effect of direct acting antivirals (DAA) therapy on cognitive function in HCV patients. We conducted a longitudinal analysis of the cognitive performance of 22 patients (8 HCV+, 14 HCV+/HIV+) who completed neuropsychological testing at baseline and at week 12 after DAA therapy. In 20 patients, we analyzed specific attention parameters derived from an experimental testing based on the Theory of Visual Attention (TVA). Depression, fatigue, and mental health were assessed as patient reported outcomes. At baseline, 54.5% of the patients met the criteria for cognitive impairment and 40% showed impairment in TVA parameters. Follow-up analysis revealed significant improvements in the domains of visual memory/learning, executive functions, verbal fluency, processing speed, and motor skills but not in verbal learning and attention/working memory. We did not observe significant improvement in visual attention measured by TVA. Fatigue and mental health significantly improved at follow-up. Our findings indicate that successful DAA treatment leads to cognitive improvements in several domains measured by standard neuropsychological testing. The absence of improvement in TVA parameters and of significant improvement in the domain of attention/working memory might reflect the persistence of specific cognitive deficits after HCV eradication. In summary, DAA treatment seems to have a positive effect on some cognitive domains and leads to an improvement in mental health and fatigue in HCV-infected patients.

KW - Clinical trial

KW - Cognitive dysfunction

KW - Direct acting antivirals

KW - Hepatitis C virus

KW - Neuropsychological assessment

KW - Theory of Visual Attention

U2 - 10.1007/s13365-018-0647-z

DO - 10.1007/s13365-018-0647-z

M3 - Journal article

C2 - 29785584

AN - SCOPUS:85047208948

SN - 1355-0284

VL - 24

SP - 557

EP - 569

JO - Journal of NeuroVirology

JF - Journal of NeuroVirology

IS - 5

ER -

Interferon-free therapy in hepatitis C virus (HCV) monoinfected and HCV/HIV coinfected patients: Effect on cognitive function, fatigue, and mental health

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this