Does HCV Affect the Brain?

May 22, 2000

DDW 5/22/00

COGNITIVE BRAIN FUNCTION IS SUBCLINICALLY IMPAIRED IN PATIENTS WITH CHRONIC

HEPATITIS C - DOES HEPATITIS C AFFECT THE BRAIN?

Ludwig Kramer, Edith Bauer, Harald Hofer, Georg Funk, Petra Munda-Steindl,

Christian Madl, Ferenci, Dept of Medicine IV, Univ of Vienna, Vienna,

Austria; Univ Hosp of Vienna, Vienna, Austria; Dept of Medicine IV, Vienna,

Austria.

Fatigue and depression occur more frequently in chronic hepatitis C virus

(HCV) infection than in other causes of chronic liver disease. However there

is no correlation between severity of hepatitis and cerebral symptoms. It

has

been hypothesized that HCV exerted a direct effect on the brain. We studied

the impact of HCV infection on sensitive markers of cognitive brain

function..

Fifty-eight noncirrhotic patients with chronic HCV infection (age, 45±13

years, mean±SD) were studied by P300 event-related potentials (an objective

measure of cognitive processing) and by the SF-36 questionnaire for

assessment of health-related quality of life. P300 latency is related to

signal-processing speed; P300 amplitude reflects the amount of conscious

attention paid to a stimulus. Findings were compared to 58 matched healthy

subjects. We found that cognitive processing was subclinically impaired in

patients (P300 latency: 361±38 ms, means±SD) as compared to healthy subjects

(344±27 ms, p=0.01). Similarly, P300 amplitude was reduced in patients with

HCV infection (12±7 vs. 18±7 µV, p<0.01). Health-related quality of life was

significantly reduced in patients with HCV infection but there was no clear

correlation between neurophysiological function and health-related quality

of

life or activity of hepatitis. In 7 out of 9 patients who were followed

during antiviral combination treatment, P300 latency was improved after 12

weeks (345±29 ms) as compared to baseline (363±48 ms, p=0.08). In

conclusion,

patients with chronic HCV infection in the absence of cirrhosis exhibit a

subclinical neurophysiological impairment. Cerebral function, however, seems

to normalize with antiviral treatment. Our data might indicate a direct

action of HCV infection on the brain.

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May 22, 2000