Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C
Open accessAbstract
UNLABELLED: 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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Several studies found no effect of IFN-α treatment on verbal fluency.
“Similarly, several studies found no effect of IFN-α treatment on verbal fluency (Amodio et al., 2005; Fontana et al., 2007; Pavol et al., 1995)”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Fontana et al., 2007
Two studies of hepatitis C patients and one of melanoma patients receiving IFN-α therapy found no effect of treatment on digit span performance.
“Similarly, two studies among hepatitis C patients (Amodio et al., 2005; Fontana et al., 2007) and one study among melanoma patients (Caraceni et al., 1998) receiving IFN-α therapy found no effect of treatment on digit span performance.”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Fontana et al., 2007
Several studies of IFN-α treated hepatitis C patients found no significant deficits on the Trail Making Test part B, the Wisconsin Card Sorting task, or the Intradimensional/Extradimensional Shift task.
“However, several other studies of IFN-α treated hepatitis C patients have found no significant performance deficits on the Trail Making Test part B (Amodio et al., 2005; Drozdz et al., 2008; Fontana et al., 2007), the Wisconsin Card Sorting task (Fontana et al., 2007), or on the Intradimensional/Extradimensional Shift task (Majer et al., 2008).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Fontana et al., 2007
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References 48 · Cited by 38
Research works printed but not linked: 3
- Shifffman ML, DiBisceglie AM, Lindsay KL, Morishima C, Wright EC, Everson GT, et al. Peginterferon alfa-2a and ribavirin in patients with chronic hepatitis C who failed prior treatment. Gastroenterology 2004; 126:1015-1023.
- Meyers CA, Scheibel RS, Forman AD. Persistent neurotoxicity of system- ically administered interferon-alpha. Neurology 1991;41:672-676.
- McCaffrey RJ, Ortega A, Orsillo SM, Neiles WB, Haase RF. Practice effects in repeated neuropsychological assessment. Clin Neuropsychol 1992;6:32-42.
- Authors
- Fontana, R. J., Bieliauskas, L. A., Lindsay, K. L., Back‐Madruga, C., Wright, E. C., Snow, K. K., Lok, A. S. F., Kronfol, Z., & Padmanabhan, L.
- Affiliations
- University of Michigan (US)
- University of Southern California (US)
- National Institutes of Health (US)
- New England Research Institutes (US)
- Corresponding author
- Fontana, Robert J.
- Venue
- Hepatology
- Published
- 2007-05
- Volume
- 45
- Issue
- 5
- Pages
- 1154-1163
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2016078859
- Cited by
- 38
- References
- 48
- Citations by year
- 2022: 3 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 1 · 2012: 3
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- University of Michigan
- Valeant Pharmaceuticals International
- New England Research Institutes
- National Institutes of Health
- Loker Hydrocarbon Research Institute, University of Southern California
- University of California, Los Angeles
- National Cancer Institute
- National Institute of Allergy and Infectious Diseases
- National Institute of Diabetes and Digestive and Kidney Diseases (N01 DK92325, N01 DK 92323, N01 DK 92328)
- National Center for Research Resources (M01 RR-00043, M-01RR00042, M01RR000043, M01RR000042)
- National Institute on Minority Health and Health Disparities
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- chronic hepatitis C, peginterferon alfa-2a, ribavirin, cognitive impairment, depression, neuropsychological assessment, retreatment, non-responders, antiviral therapy adverse effects, concentration difficulties, emotional distress
- MeSH terms
- Interferon alpha-2, Adult, Affect, Antiviral Agents, Cognition, Cognition Disorders, Female, Humans, Male, Middle Aged, Polyethylene Glycols, Recombinant Proteins, Ribavirin, Interferon-alpha, Hepatitis C, Chronic
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