Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Settings and Participants (Patients and Controls)
2.3. Procedures
2.3.1. Depression Screening
2.3.2. Liver Fibrosis Assessment
2.3.3. Blood Tests
2.3.4. Neuropsychological Instruments
2.3.5. Variables of the Study
2.4. Statistical Analysis
2.4.1. Definition of Cognitive Impairment
2.4.2. Sample Size Calculation (Power Analysis)
2.4.3. Descriptive Analysis: Demographics, Laboratory Findings, and Clinical Data
2.4.4. Main Objective: Quantitative Analysis of the Differences in Cognitive Performance between Untreated and Asymptomatic HCV Carriers (n = 28) and Healthy Controls (n = 18)
3. Results
3.1. Demographic and Clinical Data (Table 1, Table 2 and Table 3)
Demographic Characteristics | HCV Whole Sample (n = 48) | HCV Eliminated Group (n = 20) | HCV Mild Hepatitis Group (n = 28) | Control Group (n = 18) |
---|---|---|---|---|
Age (mean ± SD) | 53.89 ± 12.64 | 57.85 ± 13.17 | 51.07 ± 11.69 | 42.83 ± 15.86 |
Female (n/%) | 26 (54.16%) | 9 (45%) | 17 (60.71%) | 17 (94.44%) |
Years of Formal Education (mean ± SD) | 11.77 ± 5.03 | 10.75 ± 5.32 | 12.5 ± 4.78 | 15 ± 3.37 |
HDI (mean ± SD) | 0.81± 0.07 | 0.80 ± 0.07 | 0.81 ± 0.07 | 0.78 ± 0.05 |
Characteristics | HCV Whole Sample (n = 48) | HCV Eliminated Group (n = 20) | HCV-Mild Hepatitis Group (n = 28) | |
---|---|---|---|---|
Disease Evolution Time | Years (mean ± SD) | 12.08 ± 7.64 | 13.05 ± 7.78 | 11.39 ± 7.60 |
Transmission | Transfusion | 25 (52.08%) | 10 (50%) | 15 (53.57%) |
Sporadic | 12 (25%) | 7 (35%) | 5 (17.85%) | |
Others | 2 (4.16%) | - | 2 (7.14%) | |
Sexual | 3 (6.25%) | 1 (5%) | 2 (7.14%) | |
Illicit drugs | 6 (12.5%) | 2 (10%) | 4 (14.28%) | |
Viral genotype | Genotype (1:non 1) | 41:7 | 18:2 | 23:5 |
Grade of Fibrosis | Fibrosis (F0–F2) | 36 (75%) | 13 (65%) | 23 (82.14%) 5 (17.85%) |
Fibrosis (F3) | 6 (12.5%) | 1 (5%) | ||
Fibrosis (F4) | 6 (12.5%) | 6 (30%) | ||
Laboratory Value (mean ± SEM) | AST | 50.21 ± 5.25 | 42.13 ± 5.55 | 55.73 ± 8.03 |
ALT | 61 ± 7.56 | 49.90 ± 6.96 | 67.77 ± 11.84 | |
GGT | 73.28 ± 12.07 | 75.66 ± 16.92 | 72.04 ± 16.89 | |
TB | 0.66 ± 0.04 | 0.66 ± 0.06 | 0.67 ± 0.06 | |
Albumin | 4.23 ± 0.15 | 4.17 ± 0.12 | 4.26 ± 0.24 | |
Platelets | 214,068 ± 10,361.22 | 188,333 ± 18,440.04 | 231,885 ± 11,070.85 | |
INR | 1.03 ± 0.02 | 1.01 ± 0.01 | 1.04 ± 0.04 | |
Leukocytes | 5470 ± 237.97 | 5427 ± 390.62 | 5499 ± 304.61 | |
Hemoglobin | 13.91 ± 0.38 | 14.07 ± 0.43 | 13.80 ± 0.57 | |
Glucose | 99.27 ± 5.40 | 116.35 ± 12.30 | 88.51 ± 2.29 | |
Urea | 27.35 ± 1.29 | 31.07 ± 1.76 | 25.14 ± 1.65 | |
Creatinine | 0.81 ± 0.02 | 0.84 ± 0.03 | 0.80 ± 0.03 |
Neuropsychological Battery (Mean ± SEM) | HCV—Initial Sample (n = 48) | HCV Eliminated Group (n = 20) | Mild Hepatitis HCV Group (n = 28) | Control Group (n = 18) | |
---|---|---|---|---|---|
COWAT | FL (Animal + Fruit) + FAS | 66.2 ± 2.80 | 64.5 ± 4.48 | 67.5 ± 3.63 | 67.9 ± 3.08 |
SDMT | Number of correct answers | 32.35 ± 1.82 | 27.65 ± 2.85 | 35.71 ± 2.18 | 39.72 ± 2.56 |
OE | 2.87± 0.91 | 4.75 ± 1.88 | 1.54 ± 0.76 | 0.67 ± 0.30 | |
CVAT | CE | 6.14 ± 0.89 | 5.00 ± 0.95 | 6.96 ± 1.36 | 5.50 ± 0.59 |
RT (ms) | 453.83 ± 9.67 | 463.35 ± 16.90 | 448.18 ± 11.14 | 408.33 ± 6.84 | |
VRT (ms) | 93.0 ± 5.54 | 99.05 ± 12.47 | 88.71 ± 3.46 | 78.94 ± 3.39 |
3.2. Quantitative Analyses (Controls vs. Mild HCV)
3.2.1. Average Differences in Neuropsychological Performance between Mild HCV and Controls (Figure 2)
3.2.2. Variables That Discriminated Mild HCV from Controls
3.3. Clinical Significance of the Differences
4. Discussion
4.1. Verbal Fluency (COWAT)
4.2. SDMT
4.3. CVAT
4.4. Limitations and Strengths
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Amendola-Pires, M.M.; Fakoury, M.K.; Salazar, H.; De Oliveira, S.B.; Brandão-Mello, C.E.; Schmidt, S.L. Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease. J. Clin. Med. 2023, 12, 3910. https://doi.org/10.3390/jcm12123910
Amendola-Pires MM, Fakoury MK, Salazar H, De Oliveira SB, Brandão-Mello CE, Schmidt SL. Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease. Journal of Clinical Medicine. 2023; 12(12):3910. https://doi.org/10.3390/jcm12123910
Chicago/Turabian StyleAmendola-Pires, Marcia Maria, Max K. Fakoury, Hellen Salazar, Silvia B. De Oliveira, Carlos Eduardo Brandão-Mello, and Sergio L. Schmidt. 2023. "Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease" Journal of Clinical Medicine 12, no. 12: 3910. https://doi.org/10.3390/jcm12123910