Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C

Robert J. Fontana, Linas A. Bieliauskas, Karen L. Lindsay, Carla Back-Madruga, Elizabeth C. Wright, Kristin K. Snow, Anna S F Lok, Ziad Kronfol, Latha Padmanabhan

Research output: Contribution to journalArticle

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Abstract

Treatment of chronic hepatitis C with pegylated interferon (peginterferon) and ribavirin can cause or exacerbate depression but its effects on cognitive function are largely unknown. The aim of this study was to determine whether treatment with peginterferon and ribavirin adversely impacts cognitive function in patients with chronic hepatitis C. Prior nonresponders to interferon were retreated with peginterferon alfa-2a and ribavirin for 24 (n = 177) or 48 weeks (n = 57) in the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis trial. Cognitive function was prospectively assessed using a battery of 10 standardized neuropsychological tests at weeks 0, 24, 48, and 72. Cognitive impairment was defined based upon a global deficit score. The Beck Depression Inventory and Brief Symptom Inventory were used to assess mood status. The 57 subjects who completed 48 weeks of antiviral therapy reported significant increases in difficulty concentrating, emotional distress, and symptoms of depression, all of which improved after cessation of therapy [P < 0.0001, analysis of variance (ANOVA)]. Nonetheless, the frequency of cognitive impairment did not increase during the first 24 weeks of treatment in 177 patients (34% versus 32%, P = 0.64) nor in the 57 patients completing 48 weeks of treatment (P = 0.48, ANOVA). Conclusion: Retreatment of prior non-responders with peginterferon and ribavirin was not associated with objective evidence of cognitive impairment as measured by a comprehensive battery of neuropsychological tests. The lack of cognitive impairment is reassuring and suggests that self-reported symptoms of cognitive dysfunction are more likely related to the systemic and psychiatric side effects of antiviral treatment rather than measurable changes in cognition.

Original languageEnglish
Pages (from-to)1154-1163
Number of pages10
JournalHepatology
Volume45
Issue number5
DOIs
Publication statusPublished - May 2007
Externally publishedYes

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Retreatment
Ribavirin
Chronic Hepatitis C
Cognition
Interferons
Antiviral Agents
Neuropsychological Tests
Therapeutics
Depression
Analysis of Variance
Equipment and Supplies
Hepatitis C
Psychiatry
Fibrosis
Cognitive Dysfunction

ASJC Scopus subject areas

  • Hepatology

Cite this

Fontana, R. J., Bieliauskas, L. A., Lindsay, K. L., Back-Madruga, C., Wright, E. C., Snow, K. K., ... Padmanabhan, L. (2007). Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C. Hepatology, 45(5), 1154-1163. https://doi.org/10.1002/hep.21633

Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C. / Fontana, Robert J.; Bieliauskas, Linas A.; Lindsay, Karen L.; Back-Madruga, Carla; Wright, Elizabeth C.; Snow, Kristin K.; Lok, Anna S F; Kronfol, Ziad; Padmanabhan, Latha.

In: Hepatology, Vol. 45, No. 5, 05.2007, p. 1154-1163.

Research output: Contribution to journalArticle

Fontana, RJ, Bieliauskas, LA, Lindsay, KL, Back-Madruga, C, Wright, EC, Snow, KK, Lok, ASF, Kronfol, Z & Padmanabhan, L 2007, 'Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C', Hepatology, vol. 45, no. 5, pp. 1154-1163. https://doi.org/10.1002/hep.21633
Fontana RJ, Bieliauskas LA, Lindsay KL, Back-Madruga C, Wright EC, Snow KK et al. Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C. Hepatology. 2007 May;45(5):1154-1163. https://doi.org/10.1002/hep.21633
Fontana, Robert J. ; Bieliauskas, Linas A. ; Lindsay, Karen L. ; Back-Madruga, Carla ; Wright, Elizabeth C. ; Snow, Kristin K. ; Lok, Anna S F ; Kronfol, Ziad ; Padmanabhan, Latha. / Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C. In: Hepatology. 2007 ; Vol. 45, No. 5. pp. 1154-1163.
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abstract = "Treatment of chronic hepatitis C with pegylated interferon (peginterferon) and ribavirin can cause or exacerbate depression but its effects on cognitive function are largely unknown. The aim of this study was to determine whether treatment with peginterferon and ribavirin adversely impacts cognitive function in patients with chronic hepatitis C. Prior nonresponders to interferon were retreated with peginterferon alfa-2a and ribavirin for 24 (n = 177) or 48 weeks (n = 57) in the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis trial. Cognitive function was prospectively assessed using a battery of 10 standardized neuropsychological tests at weeks 0, 24, 48, and 72. Cognitive impairment was defined based upon a global deficit score. The Beck Depression Inventory and Brief Symptom Inventory were used to assess mood status. The 57 subjects who completed 48 weeks of antiviral therapy reported significant increases in difficulty concentrating, emotional distress, and symptoms of depression, all of which improved after cessation of therapy [P < 0.0001, analysis of variance (ANOVA)]. Nonetheless, the frequency of cognitive impairment did not increase during the first 24 weeks of treatment in 177 patients (34{\%} versus 32{\%}, P = 0.64) nor in the 57 patients completing 48 weeks of treatment (P = 0.48, ANOVA). Conclusion: Retreatment of prior non-responders with peginterferon and ribavirin was not associated with objective evidence of cognitive impairment as measured by a comprehensive battery of neuropsychological tests. The lack of cognitive impairment is reassuring and suggests that self-reported symptoms of cognitive dysfunction are more likely related to the systemic and psychiatric side effects of antiviral treatment rather than measurable changes in cognition.",
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