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Improvements in brain and behavior following eradication of hepatitis C

Journal of NeuroVirology volume 23, pages 593–602 (2017)Cite this article

Abstract

Despite recent advances in treatment, hepatitis C remains a significant public health problem. The hepatitis C virus (HCV) is known to infiltrate the brain, yet findings from studies on associated neurocognitive and neuropathological changes are mixed. Furthermore, it remains unclear if HCV eradication improves HCV-associated neurological compromise. This study examined the longitudinal relationship between neurocognitive and neurophysiologic markers among healthy HCV− controls and HCV+ adults following successful HCV eradication. We hypothesized that neurocognitive outcomes following treatment would be related to both improved cognition and white matter integrity. Participants included 57 HCV+ participants who successfully cleared the virus at the end of treatment (sustained virologic responders [SVRs]) and 22 HCV− controls. Participants underwent neuropsychological testing and, for a nested subset of participants, neuroimaging (diffusion tensor imaging) at baseline and 12 weeks following completion of HCV therapy. Contrary to expectation, group-level longitudinal analyses did not reveal significant improvement in neurocognitive performance in the SVRs compared to the control group. However, a subgroup of SVRs demonstrated a significant improvement in cognition relative to controls, which was related to improved white matter integrity. Indeed, neuroimaging data revealed beneficial effects associated with clearing the virus, particularly in the posterior corona radiata and the superior longitudinal fasciculus. Findings suggest that a subgroup of HCV+ patients experienced improvements in cognitive functioning following eradication of HCV, which appears related to positive changes in white matter integrity. Future research should examine whether any additional improvements in neurocognition and white matter integrity among SVRs occur with longer follow-up periods.

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Acknowledgments

Funding support for the current study was provided through the NIH (RO1MH083553, P.I. C.H. Hinkin). E.J. Singer is supported by the National Institutes of Health grant #1U24MH100929-01 (National Neurological AIDS Bank). T. Kuhn and P. Sayegh were supported by an NIH T32 Training Grant (MH19535; P.I. C.H.).

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Author notes

  1. Taylor Kuhn and Philip Sayegh contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 760 Westwood Plaza, #C8-749, Los Angeles, CA, 90095, USA

    Taylor Kuhn, Jacob D. Jones, Manoj K. Sarma, A. Ragin, M. Albert Thomas, April D. Thames, Steven A. Castellon & Charles H. Hinkin

  2. Psychology Service, Veterans Administration (VA) Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA

    Taylor Kuhn, Jacob D. Jones, Jason Smith, Steven A. Castellon & Charles H. Hinkin

  3. Department of Psychology, UCLA, 2191 Franz Hall, Box 951563, Los Angeles, CA, 90095, USA

    Philip Sayegh

  4. Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA

    Elyse J. Singer

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  1. Taylor Kuhn
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  2. Philip Sayegh
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Correspondence to Taylor Kuhn.

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All procedures were approved by the University of California, Los Angeles and VA Greater Los Angeles Healthcare System Institutional Review Boards. All participants provided written informed consent prior to entering the study.

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The authors declare that they have no conflict of interest.

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Kuhn, T., Sayegh, P., Jones, J.D. et al. Improvements in brain and behavior following eradication of hepatitis C. J. Neurovirol. 23, 593–602 (2017). https://doi.org/10.1007/s13365-017-0533-0

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  • DOI: https://doi.org/10.1007/s13365-017-0533-0

Keywords

  • Hepatitis C virus
  • Neurocognition
  • Neuropathology
  • Diffusion tensor imaging
  • White matter integrity
  • Sustained virologic response