HIV/HCV Co-Infection—A Dual Neurocognitive Problem

Abstract

Presence of the hepatitis C virus in HIV infected patients has an additional neurotoxic influence on the Central Nervous System. It has been described that HCV co-infection leads to neuropsychological impairment whose severity is greater than in mono-HIV infected subjects. In the present study we assessed the neuropsychological status of 46 human immunodeficiency virus (HIV)-infected individuals from the Warsaw Hospital for Infectious Diseases. For the purpose of cognitive assessment, neuropsychological tests measuring global cognitive functions, attention and perception, verbal memory, as well as non-verbal aspects of executive functions, e.g. visual monitoring and planning, were assessed. In 60% of the investigated patients, who were co-infected with the hepatitis C virus, the overall cognitive outcome observed was worse than in mono-HIV infected subjects. The following factors were taken into account: ART therapy’s influence on cognitive functions using the CPE rank (CNS Penetration Efficacy, 2010), route of HIV transmission, conditions of human existence and age of investigated patients. The present work should be treated as a preliminary research and interpreted in the context of several limitations described in the text.

Share and Cite:

K. Agnieszka, S. Bogna, C. Grazyna and S. Anna, "HIV/HCV Co-Infection—A Dual Neurocognitive Problem," World Journal of AIDS, Vol. 2 No. 1, 2012, pp. 33-41. doi: 10.4236/wja.2012.21005.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] M. D. Lezak, D. B. Howieson and D. W. Loring, “Neuropsychological Assessment,” Oxford University Press, New York, 2004.
[2] U. S. Clark, R. A. Cohen, M. L. Westbrook, K. N. Devlin and K. T. Tashima, “Facial Emotion Recognition Impairments in Individuals with HIV,” Journal of the International Neuropsychological Society, Vol. 16, No. 6, 2010, pp. 1127-1137. doi:10.1017/S1355617710001037
[3] K. A. Lindl, D. R. Marks, D. L. Kolson and K. L. Jordan-Sciutto,” HIV-Associated Neurocognitive Disorder: Pathogenesis and Therapeutic Opportunities,” Journal of Neuroimmune Pharmacology, Vol. 5, No. 3, 2010, pp. 294-309. doi:10.1007/s11481-010-9205-z
[4] T. Marcotte and J. C. Scott, “Evolution of Neuropsychological Issues in HIV-1 Infection during the HAART Era,” In: K. Goodkin, P. Shapshak, and A. Verma, Eds., The Spectrum of Neuro-AIDS Disorders: Pathology, Diagnosis and Treatment, American Society for Microbiology, Washington DC, 2008.
[5] A. Antinori, G. Arendt, J. T. Becker, B. J. Brew, D. A. Byrd, M. Cherner, D. B. Clifford, P. Cinque, L. G. Epstein, K. Goodkin, M. Gisslen, I. Grant, R. K. Heaton, J. Joseph, K. Marder, C. M. Marra, J. C. McArthur, M, Nunn, R. W. Price, L. Pulliam, K. R. Robertson, N. Sacktor, V. Valcour and V. E. Wojna, “Updated Research Nosology for HIV-Associated Neurocognitive Disorders,” Neurology, Vol. 69, No. 18, 2007, pp. 1789-1799. doi:10.1212/01.WNL.0000287431.88658.8b
[6] C. M. Marra, Y. Zhao, D. B. Clifford, S. Letendre, S. Evans, K. Henry, R. J. Ellis, B. Rodriguez, R. W. Coombs, G. Schifitto, J. C. McArthur, K. Robertson and AIDS Clinical Trials Group 736 Study Team, “Impact of Combination Antiretroviral Therapy on Cerebrospinal Fluid HIV RNA and Neurocognitive Performance,” AIDS, Vol. 23, No. 11, 2009, pp. 1359-1366. doi:10.1097/QAD.0b013e32832c4152
[7] A. Winston, C. Duncombe , P. C. K. Li, J. M. Gill, S. J. Kerr, R. Puls, K. Petoumenos, S. D. Taylor-Robinson, S. Emery and D. Cooper and Altair Study Group, “Does Choice of Combination Antiretroviral Therapy (cART) Alter Changes in Cereblar Function Testing after 48 Weeks in Treatment-Naive, HIV-1-Infected Individuals Commencing cART? A Randomized Controlled Study,” Clinical Infectious Diseases, Vol. 50, No. 6, 2010, pp. 920-929. doi:10.1086/650743
[8] M. L. Ettenhofer, C. H. Hinkin, S. A.Castellon, R. Durvasula, J. Ullman, M. Lam, H. Myers, M. J. Wright and J. Foley, “Aging, Neurocognition and Medication Adherence in HIV Infection,” American Journal of Geriatric Psychiatry, Vol. 17, No. 4, 2009, pp. 281-290. doi:10.1097/JGP.0b013e31819431bd
[9] J. J. Chen, C. B. You, W. B. Du and L. J. Li, “Prevalence of Hepatitis B and C in HIV-Infected Patients: A Meta-Analysis,” Hepatobiliary Pancreat Disease, Vol. 10, No. 2, 2001, pp. 122-127. doi:10.1016/S1499-3872(11)60020-9
[10] M. Bociaga-Jasik, B. Lickiewicz, A. Kalinowska-Nowak, A. Ciesla, T. Mach and A. Garlicki, “Neurocognitive Disorders in HIV Infected Patients,” HIV and AIDS Review, Vol. 9, No. 2, 2010, pp. 33-36. doi:10.1016/S1730-1270(10)60066-5
[11] D. M. Forton, H. C. Thomas and S. D. Taylor-Robinson, “Central Nervous System Involvement in Hepatitis C Virus Infection,” Metabolic Brain Disease, Vol. 19, No. 3-4, 2004, pp. 383-391. doi:10.1023/B:MEBR.0000043983.42843.ac
[12] D. L. Thomas, D. Leoutsakas, T. Zabransky and M. S. Kumar, “Hepatitis C in HIV-Infected Individuals: Cure and Control, Right Now,” Journal of the International AIDS Society, Vol. 14, No. 22, 2011, pp. 1-8. http://www.jiasociety.org/content/14/1/22
[13] R. Gonzalez, J. Jacobus and E. M. Martin, “Investigating Neurocognitive Features of Hepatitis C Virus in Drug Users: Potential Challenges and Lessons Learned from the HIV Literature,” Clinical Infectious Disease, Vol. 41, Suppl. 1, 2005, pp. 45-49. doi:10.1086/429495
[14] D. M. Forton, H. C. Thomas, C. A. Murphy, J. M. Allsop, G. R. Foster, J. Main, K.A. Wesnes and S. D. Taylor- Robinson, “Hepatitis C and Cognitive Impairment in a Cohort of Patients with Mild Liver Disease,” Hepatology, Vol. 35, No. 2, 2002, pp. 433-439. doi:10.1053/jhep.2002.30688
[15] L. Kramer, E. Bauer, G. Funk, H. Hofer, W. Jessner, P. Steindl-Munda, F. Wrba, C. Madl, A. Gangl and P. Ferenci, “Scubclinical Impairment of Brain Function in Chronic Hepatitis C Infection,” Journal of Hepatology, Vol. 37, No. 3, 2002, pp. 349-354. doi:10.1016/S0168-8278(02)00172-1
[16] R. C. Hilsabeck, W. Perry and T. I. Hassanein, “Neuropsychological Impairment in Patients with Chronic Hepatitis C,” Hepatology, Vol. 35, No. 2, 2002, pp. 440-446. doi:10.1053/jhep.2002.31257
[17] O. Vigil, C. Posada, S. P. Woods, J. H. Atkinson, R. K. Heaton, W. Perry, T. Hassanhein, I. Grant, S. L. Letendre and the HIV Neurobehavioral Research Center (HNRC) Group, “Impairments in Fine-Motor Coordination and Speed of Information Processing Predict Declines in Everyday Functioning in Hepatitis C Infection,” Journal of Clinical Experimental Neuropsychology, Vol. 30, No. 7, 2008, pp. 805-815. doi:10.1080/13803390701802354
[18] R. Fama, M. J. Rosenbloom, S. A. Sassoon, M. A. Thompson, A. Pfefferbaum, E. V. Sullivan, “ Remote Semantic Memory for Public Figures in HIV Infection, Alcoholism and Their Comorbidity,” Alcoholism: Clinical and Experimental Research, Vol. 35, No. 2, 2011, pp. 265-276. doi:10.1111/j.1530-0277.2010.01342.x
[19] S. P. Woods and I. Grant , “Neuropsychology of HIV,” In: H. Gendelman, I. Grant, I. Everall, S. Lipton and S. Swindelss, Eds., The Neurology of AIDS, 2nd Edition, Oxford University Press, London, 2005, pp. 357-373.
[20] C. H. Hinkin, S. A. Castellon, A. Levine, T. R. Barclay and E. J. Singer, “Neurocognition in Individuals Co-Infected with HIV and Hepatitis C,” Journal of Addictive Disorders, Vol. 27, No. 2, 2008, pp. 11-17. doi:10.1300/J069v27n02_02
[21] E. L. Ryan, S. Morgello, K. Isaacs, P. Naseer, R. N. Gerits and the Manhattan HIV Brain Bank, “Neuropsychiatric Impact of Hepatitis C on Advanced HIV,” Neurology, Vol. 62, No. 6, 2004, pp. 957-962.
[22] E. Lojek and R. A. Bornstein, “The Stability of Neurocognitive Patterns in HIV Infected Men: Classification Considerations,” Journal of Clinical and Experimental Neuropsychology, Vol. 27, No. 6, 2005, pp. 665-682. doi:10.1081/13803390490918426
[23] D. B. Clifford, M. Smurzynski, L. S. Park, T. Yeh, L. Blair, M. Arens and S. R. Evans, “Effects of Active HCV Replication on Neurologic Status in HIV RNA Virally Suppressed Patients,” Neurology, Vol. 73, No. 4, 2009, pp. 309-314. doi:10.1212/WNL.0b013e3181af7a10
[24] J. Cordoba, M. Flavia, C. Jacas, S. Sauleda, J. Esteban, V. Vargas, R. Esteban and J. Guardia, “Quality of Life and Cognitive Function in Hepatitis C at Different Stages of Liver Disease,” Journal of Hepatology, Vol. 39, No. 2, 2003, pp. 231-238. doi:10.1016/S0168-8278(03)00189-2
[25] J. Cordoba, J. Reyes, J. I. Esteban and J. M. Hernandez, ”Labeling May Be an Important Cause of Reduced Quality of Life and Cognitive Function in Chronic Hepatitis C,” American Journal of Gastroenterology, Vol. 98, No. 1, 2003, pp. 226-227.
[26] G. Szabo and S. Zakhari, “Mechanisms of Alcohol-Mediated Hepatotoxicity in Human Immunodeficiency Virus-Infected Patients,” World Journal of Gastoenterology, Vol. 17, No. 20, 2011, pp. 2500-2506. doi:10.3748/wjg.v17.i20.2500

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.