Reuters Health Information (2005-05-06): Risk of cognitive impairment high in HCV-HIV coinfection and meth addiction
Risk of cognitive impairment high in HCV-HIV coinfection and meth addiction
Last Updated: 2005-05-06 15:41:50 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Coinfection with hepatitis
C virus (HCV) increases the neuropsychological deficits observed in
patients with HIV infection and methamphetamine dependence, according
to an article in the April 26th issue of Neurology.
After starting a study of the effects of HIV and meth addiction on
cognitive function, Dr. M. Cherner and colleagues at the University of
California San Diego found that many of the 430 study participants were
also infected with HCV. They therefore investigated the effect of HCV
comorbidity on outcomes of neuropsychological testing.
Included were 190 subjects with one of the three risk factors, 110
with two and 40 with three, along with 90 normal control subjects. HCV
infection was most prevalent in those who were HIV-positive and
methamphetamine-positive (37%) and lowest among those negative for both
The prevalence of global impairment increased with the number of
risk factors (p < 0.0001). There were also additive effects on the
individual domains of learning, motor speed and dexterity, delayed
recall, and abstraction/problem solving.
Linear regression analysis adjusting for demographic factors,
methamphetamine dependence and HIV serostatus showed that HCV remained
a predictor of global impairment (p < 0.02), learning (p < 0.02),
abstraction (p < 0.02), and motor skills (p < 0.04).
The ratio of aspartate aminotransferase to alanine aminotransferase
-- a surrogate marker of liver dysfunction -- was not related to
"Because hepatitis C is potentially curable, its identification and
treatment are likely to result in improved neurobehavioral outcomes
among individuals with HIV infection and substance use disorders," Dr.
Cherner's group advises.
"Because the majority of HCV-infected adults have additional risk
factors for cognitive impairment such as drug or alcohol abuse or HIV
infection, the prevalence of cognitive impairment among these persons
may be disconcertingly high," Dr. Wilfred G. van Gorp, at Columbia
University in New York, and Dr. Charles H. Hinkin, at the David Geffen
School of Medicine at UCLA, point out in a related editorial.
Cognitive impairment can significantly affect employment status,
medication adherence, and driving safety, so patients with multiple
comorbidities should undergo careful assessment of cognitive function,
psychiatric symptoms, and daily functioning, they add.