Absence of neurocognitive effect of hepatitis C infection in HIV-coinfected people

Neurology. 2015 Jan 20;84(3):241-50. doi: 10.1212/WNL.0000000000001156. Epub 2014 Dec 10.

Abstract

Objective: To investigate the effect of hepatitis C virus (HCV) on neurocognitive performance in chronically HIV-infected patients enrolled in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study.

Methods: A total of 1,582 participants in CHARTER who were tested for HCV antibody underwent neurocognitive testing; serum HCV RNA was available for 346 seropositive patients. Neurocognitive performance was compared in 408 HCV-seropositive and 1,174 HCV-seronegative participants and in a subset of 160 seropositive and 707 seronegative participants without serious comorbid neurologic conditions that might impair neurocognitive performance, using linear regression and taking into account HIV-associated and demographic factors (including IV drug use) and liver function.

Results: Neurocognitive performance characterized by global deficit scores and the proportion of individuals who were impaired were the same in the HCV-seropositive and HCV-seronegative groups. In univariable analyses in the entire sample, only verbal domain scores showed small statistically different superior performance in the HCV+ group that was not evident in multivariable analysis. In the subgroup without significant comorbidities, scores in all 7 domains of neurocognitive functioning did not differ by HCV serostatus. Among the HCV-seropositive participants, there was no association between neurocognitive performance and serum HCV RNA concentration.

Conclusion: In HIV-infected patients, HCV coinfection does not contribute to neurocognitive impairment, at least in the absence of substantial HCV-associated liver damage, which was not evident in our cohort.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • CD4-Positive T-Lymphocytes / pathology
  • Cognition Disorders / etiology*
  • Cohort Studies
  • Female
  • HIV / genetics
  • HIV / immunology
  • HIV / pathogenicity
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • HIV Infections / pathology
  • Hepacivirus / genetics
  • Hepacivirus / immunology
  • Hepacivirus / pathogenicity
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology*
  • Hepatitis C / pathology
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Serologic Tests
  • United States
  • Viral Load

Substances

  • Anti-HIV Agents