Impairment In Hepatitis Research Articles

Predictive value of P300 event-related potential component in early cognitive impairment in patients with uncomplicated newly diagnosed hepatitis C virus

BackgroundCognitive impairment in patients with hepatitis C virus (HCV) is reported in the early onset of HCV infection without hepatic cirrhosis or marked liver impairment. Methods currently available to identify the risk for early cognitive impairment in hepatitis C virus (HCV) infection do not combine enough sensitivity and specificity. The present study aimed to evaluate the P 300 components of event-related potential (ERP) abnormalities as valid biomarkers for prediction and diagnosis of the cognitive impairment in newly diagnosed hepatitis C virus infection. This study is a case–control involved fifty patients newly diagnosed HCV and fifty age and sex-matched healthy controls. Assessments of cognitive functions were carried out by the Mini-mental State Examination, Wechsler Memory Scale Revised short form, and The Wechsler Adult Intelligence Scale, in addition to estimation of the amplitude and the latency of the P300 by the event-related potentials.ResultsNeuropsychological scales suggested the early incidence of cognitive impairment among hepatitis C virus patients. The electrophysiological study showed significant prolongation of P300 latency and decreased amplitude in HCV patients group compared with the control group. A binary logistic regression detected that P 300 latency ≥ 369 ms was significantly accompanied by a threefold increased risk of impaired cognition (OR 3.09, 95% CI 1.59–5.72, P < 0.01), while P 300 amplitude ≤ 8.2 μv was significantly accompanied by a twofold increased risk of impaired cognition (OR 2.18, 95% 1.43–4.05, P < 0.01).ConclusionThis study concluded that the P300 event-related potentials components are valid biomarker as easy, noninvasive assessment and cost-effective method of early cognitive impairment in patients with uncomplicated newly diagnosed hepatitis C virus.Registration of Clinical Trial ResearchClinicalTrials.gov ID: NCT04389268. https://clinicaltrials.gov/ct2/show/NCT04389268

Progressive Disruption of Dynamic Functional Network Connectivity in Patients With Hepatitis B Virus-related cirrhosis.

The diseased-related dynamic functional network connectivity (dFNC) disruption and its relationship with cognitive impairment in hepatitis B virus-related cirrhosis (HBV-RC) patients with minimal hepatic encephalopathy (MHE) and no MHE (NMHE) remain unknown. This knowledge would help identify MHE pathophysiology and monitor disease progression in HBV-RC patients. To investigate the dFNC in patients with NMHE and MHE and the relationship between dFNC indices with the psychometric hepatic encephalopathy score (PHES). Prospective. Thirty HBV-RC patients (including 17 NMHE and 13 MHE) and 38 healthy controls (HC). A 1.5 T MRI and gradient-echo echo-planar imaging and fast field echo three-dimensional T1-weighted imaging. The independent components, dFNC matrix and dFNC indices (mean dwell times [DT], number of states, number of transitions, and fraction time in each state), were obtained through GIFT package. Cognitive measurement and patients grouping were based on PHES tests. One-way ANOVA, chi-square test, two-sample t-test, Kruskal-Wallis test, spearman's correlation analysis and the false discovery rate. Significance level: P < 0.05. Compared to HC (21.1 ± 4.02), the DT of state 1 decreased in NMHE (9.0 ± 3.04, P = 0.062, 95% confidence interval [CI] is -0.65 to 24.88) and significantly in MHE stage (1.2 ± 1.01) and was significantly correlated with PHES (r = 0.5) for all patients. The DT of state 2 increased gradually in NMHE (75.2 ± 13.10, P = 0.052, 95% CI, -54.23 to 0.28) and significantly in MHE stage (94.6 ± 15.61) when compared to HC (48.2 ± 6.97). Moreover, the connectivity between cognitive control network (CCN) and visual network (VIS) in state 1 (0.7 ± 0.79) and between default mode (DMN) and VIS in state 2 (-0.2 ± 0.29) decreased significantly in MHE when compared to HC (0.1 ± 0.68 for CCN-VIS in state 1 and 0.1 ± 0.17 for DMN-VIS for state 2). DATA CONCLUSION: dFNC exhibited progressive impairment as the disease advances in patients with HBV-RC. 2 TECHNICAL EFFICACY: Stage 2.

Direct antivirals and cognitive impairment in hepatitis C: a clinical-neurophysiologic study

Cognition was assessed in hepatitis C virus (HCV) patients, who did not meet the criteria for a minimal hepatic encephalopathy. Their liver function was compensated. We then disentangled potential cognitive changes associated with a sustained virologic response at 12 weeks (SVR-12), following treatment with direct antiviral agents (DAAs). We studied 23 selected HCV patients with a battery of standard neuropsychological tests, and with recordings of the P300 wave, a cerebral potential of “cognitive” significance. There was a baseline evaluation (T0) and a second one 6 months later (T1). We had 2 control groups of comparable age and sex, i.e., 15 patients suffering from non-alcoholic fatty liver disease (NAFLD) and 15 healthy subjects. At T0, we detected a significant (p < 0.05) cognitive impairment in the HCV group, which involved episodic and working memory, attention, visuospatial and verbal abilities, executive functions, and logic reasoning. The P300 latency was significantly (p < 0.05) delayed in the group. At T1, we observed some significant (p < 0.05) HCV recovery in given test domains, e.g., memory, executive functions, and reasoning. Accordingly, the P300 latency shortened significantly (p < 0.05). HCV patients exhibited subtle cognitive defects, somehow independent of their liver condition, possibly linked to direct or indirect brain involvement by the virus. These defects partly recovered following the SVR-12, as achieved through DAAs. The P300 wave was a valid neurophysiologic counterpart of these changes. DAAs can have a role in the early preservation of cognition in HCVs.

A Study on Quality of Life and Cognitive Impairment in Hepatitis C Positive Patients Receiving Interferon Therapy

A Study on Quality of Life and Cognitive Impairment in Hepatitis C Positive Patients Receiving Interferon Therapy

Serum lipid profile as a marker of liver impairment in hepatitis B Cirrhosis patients

BackgroundChronic HBV infection is a major cause of Cirrhosis and an important risk factor to develop hepatocellular carcinoma. The study is conducted to find out the changes in the lipid metabolism of HBV-cirrhosis patients.MethodsIn the present study, serum lipid profiles of patients with HBV-cirrhosis were assessed by utilizing micro-lab and gas chromatography, while risk factors for transmission of HBV-cirrhosis studied through the standard questionnaire.ResultsThe epidemiological and etiological risk factors strongly associated with HBV-cirrhosis patients compared to controls, included as family history, shave from the barber, blood transfusion (without proper screening), mutual sharing of household contents, positive surgery history, and dental treatment. The HBV-cirrhosis patients have significantly lower level (p < 0.001) of lipid profile including total cholesterol (96.65 mg/dl), TAG (82.85 mg/dl), VLDL-C (16.57 mg/dl), LDL-C (68.27 mg/dl), HDL-C (27 mg/dl) and total lipid (424.76 mg/dl) in comparison to controls, indicating hypolipidemia in patients. The MELD score indicated mild prognostic values of the hepatic function for the study group. The result of total fatty acid composition of HBV-cirrhotic patients with comparison of control subjects reveals that palmitic (24.54 g/100 g) and palmitoleic acid (4.65 g/100 g) were significantly (p < 0.05) higher whereas eicosatrienoic (0.09 g/100 g), arachidonic (3.57 g/100 g), linoleic (22.75 g/100 g) and α-linolenic acid (0.12 g/100 g) were significantly lower. Marker for stearoyl-CoA desaturase (SCD = ∆9-desaturase) activity i.e. palmitoleic: palmitic (0.2) and oleic: stearic acid (1.5) ratios, originated higher in HBV-cirrhotic patients, while PUFA: SFA (0.6) was lower in HBV-cirrhosis patients as compared with control subjects. The serum SFA and MUFA were increased while PUFA were reduced in both total and free form.ConclusionPresent study concluded that hypolipidemia observed in HBV-cirrhosis patients, MELD were found to be independent predictors of survival and alteration in fatty acid composition, possibly due to impairment in fatty acid metabolism by enzymatic elongation and desaturation.

Predictors of Neurocognitive Impairment in Hepatitis C Viral Infection

Predictors of Neurocognitive Impairment in Hepatitis C Viral Infection

Interferon-induced depression and cognitive impairment in hepatitis C virus patients: a 72 week prospective study

This study assessed the rates and course of depressive symptomatology and neurocognitive deficits in hepatitis C virus (HCV) patients undergoing interferon treatment, and explored possible predictors of depression and neurocognitive deficits. In order to obtain objective assessments of depression, and to evaluate cognitive impairment, a 72-week prospective study, comprising 48 weeks of treatment and 24 weeks of post-treatment follow-up was utilized. A total of 50 HCV patients were assessed at baseline, and 14 times during pegylated interferon plus ribavirin treatment. Patients were also assessed on four timepoints after the termination of treatment. All patients have previously been treated for hepatitis C infection with interferon and were judged to be treatment resistant in these treatments. Depression was assessed using the Center for Epidemiological Studies Depression (CES-D) questionnaire, and patients were interviewed regarding problems with memory, attention and concentration. Eighty-two per cent of interferon-treated patients developed severe enough depressive symptoms to meet the CES-D criteria for possible major depressive disorder (MDD). Possible MDD onset was most frequent by the first week of treatment, and almost all possible MDD cases were observed by week 8. More severe depressive symptoms at baseline were associated with higher depressive symptoms during interferon treatment. Thirty per cent of patients complained about cognitive problems. In half of these patients cognitive impairments were still reported after the termination of treatment. There was no association between depression during interferon treatment and subjective cognitive complaints. The findings suggest that depression and cognitive impairments are frequent and persistent side-effects of interferon treatment in treatment-resistant patients.