Attention abnormalities in chronic hepatitis c (CHC) patients during peg-interferon alpha and ribavirin (peg-IFNalpha/RBV) therapy may persist after treatment discontinuation

Abstract

Persistence of various cognitive abnormalities was observed after peg-IFNalpha/RBV therapy discontinuation. The literature concerning CHC patients was scarce and inconclusive.

The aim of the study was to answer the question whether peg-IFNalpha/RBV-induced cognitive functions' disturbances resolve eight weeks after treatment discontinuation.

26 CHC patients were consecutively enrolled in the study. They were given peg-IFNalpha/RBV treatment for 48 weeks in the standard doses recommended by manufacturers. Patients underwent neuropsychological examination consisting of Stroop Color Word Test (SCWT), Trail Marking Test (TMT), Auditory Verbal Learning Test (AVLT), Attention d2 Test (d2) and Hooper Visual Organization Test (HVOT) three times: before the beginning (t=0), after 12 weeks of medication (t=1) and 8 weeks after treatment discontinuation (t=2).

Cognitive performance measured by means of all mentioned tests decreased significantly after 12 weeks of combination therapy. However, no significant differences in the results of TMT, AVLT, HVOT and SCWT color words subtest between t=0 and t=2 were seen, significance between these two time points in d2 and SCWT colors and words subtests performance was observed. SCWT subtests results revealed a trend towards normalization but d2 performance in t=2 was ever poorer comparing with t=1.

The findings suggest that most cognitive disturbances observed during peg-IFNalpha/RBV therapy in CHC patients resolve eight weeks after treatment discontinuation, but attention abnormalities may persist up to 8 weeks after treatment of discontinuation. The complete resolution of attention abnormalities observed during peg-IFNalpha/RBV therapy may require longer period or may be the effect of the permanent anterior cingulate cortex damage.