Cognitive Function Does Not Worsen During Long-Term Low-Dose Peginterferon Therapy in Patients With Chronic Hepatitis C

January 31, 2010

Am J Gastroenterol. 2010 Jan 26. [Epub ahead of print]

Cognitive Function Does Not Worsen During Long-Term Low-Dose Peginterferon

Therapy in Patients With Chronic Hepatitis C.

Fontana RJ, Bieliauskas LA, Back-Madruga C, KL, Litman HJ, Lok AS,

Kronfol Z.

Division of Gastroenterology, Department of Internal Medicine, University of

Michigan, Ann Arbor, Michigan, USA.

OBJECTIVES:Neuropsychiatric toxicity is a common dose-limiting side effect of

interferon therapy. The primary aim of this study was to determine whether

patients receiving long-term low-dose peginterferon therapy had a higher

incidence of cognitive side effects compared with untreated patients enrolled in

the Hepatitis C Antiviral Long-Term treatment against Cirrhosis (HALT-C)

Trial.METHODS:A total of 129 patients with chronic hepatitis C and advanced

fibrosis completed a battery of 10 neuropsychological tests and the Beck

Depression Inventory at pretreatment baseline and at months 12, 24, 36, and 48

while receiving long-term peginterferonalpha2a (90 mug/week) or no therapy

during the randomized phase of the HALT-C Trial. Cognitive impairment was

defined as a global deficit score (GDS) >/=1.0.RESULTS:The mean age was 51.2

years, 67% were male, and 42% had cirrhosis. After accounting for baseline GDS

scores, the mean GDS scores did not significantly change over time (P=0.46) nor

with treatment group (P=0.49). Cognitive function was also not influenced by

medication adherence in the 66 patients receiving maintenance peginterferon

(P=0.14) after controlling for baseline GDS scores and time. Beck Depression

scores did not significantly increase over time (P=0.60), nor did they vary by

treatment group (P=0.74). Although 32% of patients experienced objective

worsening of their liver disease during follow-up, the frequency and severity of

cognitive impairment did not differ in those with and without disease

progression (P=0.71).CONCLUSIONS:Measures of cognitive function were neither

influenced by low-dose peginterferon treatment nor with objective evidence of

liver disease progression in patients with advanced chronic hepatitis C

prospectively followed up for 3.5 years.Am J Gastroenterol advance online

publication, 26 January 2010; doi:10.1038/ajg.2010.3.

PMID: 20104219 [PubMed - as supplied by publisher]

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