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Abstract
Objective: To investigate the effect of hepatitis C virus (HCV) on neurocognitive performance in chronically HIV-infected patients enrolled in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) study.
Methods: A total of 1,582 participants in CHARTER who were tested for HCV antibody underwent neurocognitive testing; serum HCV RNA was available for 346 seropositive patients. Neurocognitive performance was compared in 408 HCV-seropositive and 1,174 HCV-seronegative participants and in a subset of 160 seropositive and 707 seronegative participants without serious comorbid neurologic conditions that might impair neurocognitive performance, using linear regression and taking into account HIV-associated and demographic factors (including IV drug use) and liver function.
Results: Neurocognitive performance characterized by global deficit scores and the proportion of individuals who were impaired were the same in the HCV-seropositive and HCV-seronegative groups. In univariable analyses in the entire sample, only verbal domain scores showed small statistically different superior performance in the HCV+ group that was not evident in multivariable analysis. In the subgroup without significant comorbidities, scores in all 7 domains of neurocognitive functioning did not differ by HCV serostatus. Among the HCV-seropositive participants, there was no association between neurocognitive performance and serum HCV RNA concentration.
Conclusion: In HIV-infected patients, HCV coinfection does not contribute to neurocognitive impairment, at least in the absence of substantial HCV-associated liver damage, which was not evident in our cohort.
GLOSSARY
- APRI=
- AST to platelet ratio index;
- CHARTER=
- CNS HIV Antiretroviral Therapy Effects Research;
- CLIA=
- Clinical Laboratory Improvement Amendments;
- FIB4=
- fibrosis 4 index;
- GDS=
- global deficit scores;
- HAND=
- HIV-associated neurocognitive disorders;
- HCV=
- hepatitis C virus;
- MELD=
- Model for End-stage Liver Disease;
- NP=
- neuropsychological;
- WRAT-3=
- Wide Range Achievement Test–oral reading score
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Coinvestigators are listed on the Neurology® Web site at Neurology.org.
Editorial, page 222
Supplemental data at Neurology.org
- Received April 7, 2014.
- Accepted in final form August 18, 2014.
- © 2014 American Academy of Neurology
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