Skip to main content

Advertisement

SpringerLink
Log in

Comparison of cognitive performance in HIV or HCV mono-infected and HIV–HCV co-infected patients

  • Clinical and Epidemiological Study
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Purpose

Our aim was to explore the interplay between human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections in the expression of cognitive disorders.

Methods

We performed a multi-centre cross-sectional study, enrolling three groups of asymptomatic outpatients matched for age and education: (1) HIV mono-infected; (2) HCV mono-infected; (3) HIV–HCV co-infected. All subjects were subjected to the Zung depression scale and a comprehensive neuropsychological battery.

Results

A total of 50 patients for each group were enrolled. Patients in the three groups did not significantly differ in the main common demographic and clinical characteristics, except for a lower proportion of past injecting drug use (IDU) in group 1 (4 %) in comparison to groups 2 (38 %, p < 0.001) and 3 (78 %, p < 0.001), a longer duration of HIV infection in group 3 in comparison to group 1 (p < 0.001) and a longer duration of HCV infection in group 3 in comparison to group 2 (p = 0.028). Overall, 39.3 % of patients showed minor cognitive impairment, with a higher proportion in group 3 (54 %) when compared to groups 1 (28 %, p = 0.015) or 2 (36 %, p = 0.108). Patients in group 3 [odds ratio (OR) 3.35, p = 0.038 when compared to group 1] and those with higher depression scores (OR 1.05, p = 0.017) showed an increased risk of cognitive impairment after adjusting for education and past injection drug use. In particular, group 3 showed worse performance in psychomotor speed tasks when compared to group 1 (p = 0.033).

Conclusions

A worse cognitive performance in HIV–HCV co-infected patients was observed, suggesting an additive role of the two viruses in the pathogenesis of cognitive disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. McArthur JC. HIV dementia: an evolving disease. J Neuroimmunol. 2004;157:3–10.

    Article  PubMed  CAS  Google Scholar 

  2. UNAIDS. AIDS epidemic update 2009. Available at: http://www.unaids.org/en/media/unaids/contentassets/dataimport/pub/report/2009/jc1700_epi_update_2009_en.pdf. Accessed 7 July 2013.

  3. Cysique LA, Brew BJ. Neuropsychological functioning and antiretroviral treatment in HIV/AIDS: a review. Neuropsychol Rev. 2009;19:169–85.

    Article  PubMed  Google Scholar 

  4. Ciccarelli N, Fabbiani M, Di Giambenedetto S, Fanti I, Baldonero E, Bracciale L, et al. Efavirenz associated with cognitive disorders in otherwise asymptomatic HIV-infected patients. Neurology. 2011;76:1403–9.

    Article  PubMed  CAS  Google Scholar 

  5. Fabbiani M, Ciccarelli N, Tana M, Farina S, Baldonero E, Di Cristo V, et al. Cardiovascular risk factors and carotid intima-media thickness are associated with lower cognitive performance in HIV-infected patients. HIV Med. 2013;14:136–44.

    Article  PubMed  CAS  Google Scholar 

  6. Sacktor N, Skolasky R, Selnes OA, Watters M, Poff P, Shiramizu B, et al. Neuropsychological test profile differences between young and old human immunodeficiency virus-positive individuals. J Neurovirol. 2007;13:203–9.

    Article  PubMed  Google Scholar 

  7. Sherman KE, Rouster SD, Chung RT, Rajicic N. Hepatitis C Virus prevalence among patients infected with Human Immunodeficiency Virus: a cross-sectional analysis of the US adult AIDS Clinical Trials Group. Clin Infect Dis. 2002;34:831–7.

    Article  PubMed  Google Scholar 

  8. Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001;345:41–52.

    Article  PubMed  CAS  Google Scholar 

  9. Sulkowski MS, Thomas DL. Hepatitis C in the HIV-infected patient. Clin Liver Dis. 2003;7:179–94.

    Article  PubMed  Google Scholar 

  10. Caudai C, Maimone D, Almi P, Annunziata P, Bastianoni I, Boggiano CA, et al. The potential role of hepatitis C virus in the pathogenesis of the neurological syndrome in chronic hepatitis C. Gut. 1997;41:411–2.

    Article  PubMed  CAS  Google Scholar 

  11. Clifford DB, Evans SR, Yang Y, Gulick RM. The neuropsychological and neurological impact of hepatitis C virus co-infection in HIV-infected subjects. AIDS. 2005;19:S64–71.

    Article  PubMed  Google Scholar 

  12. Forton DM, Allsop JM, Cox IJ, Hamilton G, Wesnes K, Thomas HC, et al. A review of cognitive impairment and cerebral metabolite abnormalities in patients with hepatitis C infection. AIDS. 2005;19:S53–63.

    Article  PubMed  Google Scholar 

  13. Letendre S, Paulino AD, Rockenstein E, Adame A, Crews L, Cherner M, et al. Pathogenesis of hepatitis C virus coinfection in the brains of patients infected with HIV. J Infect Dis. 2007;196:361–70.

    Article  PubMed  CAS  Google Scholar 

  14. Richardson JL, Nowicki M, Danley K, Martin EM, Cohen MH, Gonzalez R, et al. Neuropsychological functioning in a cohort of HIV- and hepatitis C virus-infected women. AIDS. 2005;19:1659–67.

    Article  PubMed  Google Scholar 

  15. Vivithanaporn P, Nelles K, DeBlock L, Newman SC, Gill MJ, Power C. Hepatitis C virus co-infection increases neurocognitive impairment severity and risk of death in treated HIV/AIDS. J Neurol Sci. 2012;312:45–51.

    Article  PubMed  Google Scholar 

  16. Hilsabeck RC, Perry W, Hassanein TI. Neuropsychological impairment in patients with chronic hepatitis C. Hepatology. 2002;35:440–6.

    Article  PubMed  Google Scholar 

  17. Thein H, Maruff P, Krahn M, Kaldor J, Koorey DJ, Brew B, et al. Cognitive function, mood and health-related quality of life in hepatitis C virus (HCV)-monoinfected and HIV/HCV-coinfected individuals commencing HCV treatment. HIV Med. 2007;8:192–202.

    Article  PubMed  Google Scholar 

  18. Heaton RK, Cysique LA, Jin H, Shi C, Yu X, Letendre S, et al. Neurobehavioral effects of human immunodeficiency virus infection among former plasma donors in rural China. J Neurovirol. 2008;14:536–49.

    Article  PubMed  Google Scholar 

  19. Letendre S, Ellis R, Deutsch R, Clifford D, Marra C, McCutchan A, et al. Correlates of time-to-loss-of-viral-response in CSF and plasma in the CHARTER cohort. In: 17th Conference on Retroviruses and Opportunistic Infections (CROI); San Francisco, California, February 2010.

  20. Ciccarelli N, Fabbiani M, Colafigli M, Trecarichi EM, Silveri MC, Cauda R, et al. Revised central nervous system neuropenetration-effectiveness score is associated with cognitive disorders in HIV-infected patients with controlled plasma viraemia. Antivir Ther. 2013;18:153–60.

    Article  PubMed  Google Scholar 

  21. Capitani E, Laiacona M. Composite neuropsychological batteries and demographic correction: standardization based on equivalent scores, with a review of published data. The Italian Group for the Neuropsychological Study of Ageing. J Clin Exp Neuropsychol. 1997;19:795–809.

    Article  PubMed  CAS  Google Scholar 

  22. Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, et al. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007;69:1789–99.

    Article  PubMed  CAS  Google Scholar 

  23. Kramer L, Bauer E, Funk G, Hofer H, Jessner W, Steindl-Munda P, et al. Subclinical impairment of brain function in chronic hepatitis C infection. J Hepatol. 2002;37:349–54.

    Article  PubMed  Google Scholar 

  24. Forton DM, Taylor-Robinson SD, Thomas HC. Cerebral dysfunction in chronic hepatitis C infection. J Viral Hepat. 2003;10:81–6.

    Article  PubMed  CAS  Google Scholar 

  25. Forton DM, Thomas HC, Murphy CA, Allsop JM, Foster GR, Main J, et al. Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology. 2002;35:433–9.

    Article  PubMed  Google Scholar 

  26. Ammassari A, Antinori A, Aloisi MS, Trotta MP, Murri R, Bartoli L, et al. Depressive symptoms, neurocognitive impairment, and adherence to highly active antiretroviral therapy among HIV-infected persons. Psychosomatics. 2004;45:394–402.

    Article  PubMed  Google Scholar 

  27. Stern RA, Silva SG, Chaisson N, Evans DL. Influence of cognitive reserve on neuropsychological functioning in asymptomatic human immunodeficiency virus-1 infection. Arch Neurol. 1996;53:148–53.

    Article  PubMed  CAS  Google Scholar 

  28. Bieliauskas LA, Back-Madruga C, Lindsay KL, Wright EC, Kronfol Z, Lok AS, et al. Cognitive reserve and neuropsychological functioning in patients infected with hepatitis C. J Int Neuropsychol Soc. 2007;13:687–92.

    Article  PubMed  Google Scholar 

  29. Canestri A, Lescure FX, Jaureguiberry S, Moulignier A, Amiel C, Marcelin AG, et al. Discordance between cerebral spinal fluid and plasma HIV replication in patients with neurological symptoms who are receiving suppressive antiretroviral therapy. Clin Infect Dis. 2010;50:773–8.

    Article  PubMed  Google Scholar 

  30. Cavassini M, Du Pasquier RA. A light in the cognitive fog? Antivir Ther. 2013;18:149–51.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

No specific funding was received for this study.

Conflict of interest

M.F. received speakers’ honoraria from Abbott Virology, Merck Sharp & Dohme and Janssen-Cilag. K.F. received speakers’ honoraria from Bristol-Myers Squibb. M.C. has been a paid consultant for Merck Sharp & Dohme, Italy and was employed by Bristol-Myers-Squibb, Italy from May 10th, 2010 to February 28th 2011. M.C.S. received travel grants from Novartis and Lundbeck, and research support from the Catholic University of Rome. J.V. received speakers’ honoraria from Gilead, Bristol-Myers Squibb, Abbott, Janssen-Cilag and ViiV. R.C. has been an advisor for Gilead and Janssen-Cilag, received speakers’ honoraria from ViiV, Bristol-Myers Squibb, Merck Sharp & Dohme and Janssen-Cilag, and research support from “Fondazione Roma”. S.D.G. received speakers’ honoraria and support for travel to meetings from Gilead, Bristol-Myers Squibb, Abbott, Boehringer Ingelheim, Janssen-Cilag and GlaxoSmithKline. The other authors have nothing to declare.

Author information

Authors and Affiliations

  1. Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, Rome, 00168, Italy

    N. Ciccarelli, M. Fabbiani, E. Baldonero, M. Colafigli, R. Cauda & S. Di Giambenedetto

  2. Memory Clinic, Catholic University of Sacred Heart, Largo Agostino Gemelli 8, Rome, 00168, Italy

    N. Ciccarelli, E. Baldonero & M. C. Silveri

  3. Division of Infectious Diseases, S. Caterina Novella Hospital, Via Roma, Galatina (Lecce), 73013, Italy

    P. Grima & M. Tana

  4. Infectious Diseases Clinic, University of Chieti, Via dei Vestini, Chieti, 66100, Italy

    K. Falasca & J. Vecchiet

Authors
  1. N. Ciccarelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Fabbiani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Grima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Falasca
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Tana
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Baldonero
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Colafigli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. C. Silveri
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. Vecchiet
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. R. Cauda
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. S. Di Giambenedetto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Fabbiani.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ciccarelli, N., Fabbiani, M., Grima, P. et al. Comparison of cognitive performance in HIV or HCV mono-infected and HIV–HCV co-infected patients. Infection 41, 1103–1109 (2013). https://doi.org/10.1007/s15010-013-0503-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-013-0503-2

Keywords

Search

Navigation