Pawłowski Tomasz, Radkowski Marek, Perlejewski Karol, Szymańska Bogna, Berak Hanna, Horban Andrzej, Laskus Tomasz
Department of Psychiatry, Wrocław Medical University, Wrocław, Poland.
Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, Warsaw, Poland.
PLoS One. 2025 Apr 4;20(4):e0320221. doi: 10.1371/journal.pone.0320221. eCollection 2025.
The aim of the study was to determine how depression and cognitive dysfunction in patients with chronic hepatitis C virus (HCV) infection are affected by treatment with direct-acting antivirals (DAA). Fifty-two chronic hepatitis C patients underwent neurocognitive and psychological evaluation before therapy and 5-6 months later. Depression was measured by Beck Depression Inventory (BDI), anxiety by State-Trait Anxiety inventory (STAI), neuroticism by Eysenck Personality Inventory (N/EPO-R), while Ruff Figural Fluency Test (RFFT), Wisconsin Card Sorting Test (WCST), The Grooved Pegboard Test (GPT), and California Verbal Learning Test (CVLT) were used to assess neurocognitive function. There was significant positive change in BDI scores (8.8 ± 6.6 vs 6.1 ± 6.1; p < 0.0001) while the most striking improvement in cognitive tests was observed for CVLT sum of immediate recall from Trial-1 to Trial-5 (50.9 ± 10.0 to 54.1 ± 10.0; p = 0.0005) and RFFT, where the number of unique designs increased from 77.2 ± 21.0 to 86.1 ± 28.3 (p < 0.0001). These differences remained significant when patients with advanced (METAVIR grade F3/F4) and those with mild (grade F0/F1/F2) liver disease were analyzed separately, although in general the improvements were more pronounced in the former group. In conclusion, in chronic HCV infection the brain function is markedly improved by DAA treatment.
本研究的目的是确定直接作用抗病毒药物（DAA）治疗如何影响慢性丙型肝炎病毒（HCV）感染患者的抑郁和认知功能障碍。52例慢性丙型肝炎患者在治疗前及治疗5 - 6个月后接受了神经认知和心理评估。采用贝克抑郁量表（BDI）测量抑郁，状态-特质焦虑量表（STAI）测量焦虑，艾森克人格问卷（N/EPO-R）测量神经质，同时使用鲁夫图形流畅性测试（RFFT）、威斯康星卡片分类测试（WCST）、沟槽钉板测试（GPT）和加利福尼亚言语学习测试（CVLT）评估神经认知功能。BDI评分有显著的正向变化（8.8±6.6 vs 6.1±6.1；p<0.0001），而认知测试中最显著的改善见于CVLT从试验1到试验5的即时回忆总和（50.9±10.0至54.1±10.0；p = 0.0005）以及RFFT，其中独特设计的数量从77.2±21.0增加到86.1±28.3（p<0.0001）。当分别分析晚期（METAVIR F3/F4级）和轻度（F0/F1/F2级）肝病患者时，这些差异仍然显著，尽管总体而言前一组的改善更为明显。总之，在慢性HCV感染中，DAA治疗可显著改善脑功能。
