Hilsabeck Robin C, Hassanein Tarek I, Carlson Meghan D, Ziegler Elizabeth A, Perry William
Department of Neuropsychiatry & Behavioral Science, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA.
J Int Neuropsychol Soc. 2003 Sep;9(6):847-54. doi: 10.1017/S1355617703960048.
Hepatitis C virus (HCV) infection is a major public-health-care problem, with over 170 million infected worldwide. Patients with chronic HCV infection often complain of various cognitive problems as well as symptoms of depression, anxiety, and fatigue. Relatively little is known, however, about the specific cognitive deficits that are common among HCV patients, and the influence of psychiatric symptomatology on cognitive functioning. In the current study of 21 chronically infected HCV patients, we assessed subjective cognitive dysfunction, depression, anxiety, and fatigue and compared these symptom areas to cognitive tests assessing visuoconstruction, learning, memory, visual attention, psychomotor speed, and mental flexibility. Results revealed that cognitive impairment ranged from 9% of patients on a visuoconstruction task to 38% of patients on a measure of complex attention, visual scanning and tracking, and psychomotor speed, and greater HCV disease severity as indicated by liver fibrosis was associated with greater cognitive dysfunction. Objective cognitive impairment was not related to subjective cognitive complaints or psychiatric symptomatology. These findings suggest that a significant portion of patients with chronic HCV experience cognitive difficulties that may interfere with activities of daily living and quality of life. Future research using cognitive measures with HCV-infected patients may assist researchers in identifying if there is a direct effect of HCV infection on the brain and which patients may be more likely to progress to cirrhosis and hepatic encephalopathy.
丙型肝炎病毒（HCV）感染是一个重大的公共卫生保健问题，全球有超过1.7亿人受到感染。慢性HCV感染患者经常抱怨各种认知问题以及抑郁、焦虑和疲劳症状。然而，对于HCV患者中常见的特定认知缺陷以及精神症状学对认知功能的影响，我们了解得相对较少。在当前对21名慢性感染HCV患者的研究中，我们评估了主观认知功能障碍、抑郁、焦虑和疲劳，并将这些症状领域与评估视觉构建、学习、记忆、视觉注意力、心理运动速度和心理灵活性的认知测试进行了比较。结果显示，认知障碍的发生率从视觉构建任务中9%的患者到复杂注意力、视觉扫描和跟踪以及心理运动速度测量中38%的患者不等，并且肝纤维化所表明的更高的HCV疾病严重程度与更严重的认知功能障碍相关。客观认知障碍与主观认知主诉或精神症状学无关。这些发现表明，相当一部分慢性HCV患者存在认知困难，这可能会干扰日常生活活动和生活质量。未来对HCV感染患者使用认知测量方法的研究可能有助于研究人员确定HCV感染是否对大脑有直接影响，以及哪些患者更有可能进展为肝硬化和肝性脑病。
