Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 1, January-February, p. 167–175

doi: 10.17219/acem/37787

Publication type: review

Language: English

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The neuropsychiatric aspect of the HCV infection

Magdalena Więdłocha1,A,B,C,D, Piotr Marcinowicz2,C,D,F, Dorota Sokalla3,C,D, Bartłomiej Stańczykiewicz4,A,E,F

1 Masovian Specialist Health Center, Pruszków, Poland

2 Lower Silesian Centre of Lung Diseases, Wrocław, Poland

3 Department of Pediatric Bone Narrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Poland

4 Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Poland

Abstract

HCV infection is significantly more prevalent in the population of psychiatric patients, drug addicts and people tending to undertake risky sexual behaviors than in the general population. This article presents a spectrum of psychopathological symptoms and psychological dysfunctions, an outline of current theories on the neuropathology and psychiatric aspects of HCV infection treatment. The unspecific character of the psychopathological symptoms in the HCV infection makes the process of thorough diagnostics and adequate treatment difficult, thus the specific and characteristic features have been emphasized. The aim of this review is to shed light not only on the basic information concerning CNS pathology but also on the conclusions emerging from the studies of different authors, of various methodology, in diverse study groups and also to investigate current topics of research. The results of neuroimaging studies have been presented as well. Attention has also been dedicated separately to specific issues, like psychiatric aspects of co-infection with HCV and HIV viruses, the chronic fatigue in the course of HCV infection, the influence of substance use disorders and difficulties encountered during treatment with interferon. Undiagnosed psychiatric disorders, not only inevitably decrease the already rather low quality of life but also cause non-adherence with recommendations and medications regimes, contributing to a worse treatment outcome. Finally, the above disorders, when left untreated, result in higher rates of risk-taking behaviors among the infected, thus imposing a danger not only to patients themselves but also to the healthy population.

Key words

mental disorders, neuropathology, HCV infection, HIV infection

References (44)

  1. Rifai MA, Gleason OC, Sabouni D. Psychiatric care of the patient with hepatitis C: A review of the literature. Prim Care Companion J Clin Psychiatry. 2010, 12(6).
  2. Fletcher NF, McKeating JA. Hepatitis C virus and the brain. J Viral Hepat. 2012;19:301–306.
  3. Modabbernia A, Poustchi H, Malekzadeh R. Neuropsychiatric and psychosocial issues of patients with hepatitis c infection: A selective liter-ature review. Hepat Mon. 2013;13(1).
  4. Perry W, Hilsabeck RC, Hassanein TI. Cognitive dysfunction in chronic hepatitis C: A review. Dig Dis Sci. 2008;53(2):307–321.
  5. Batista-Neves SC, Quarantini LC, Galvão de Almeida A, et al. High frequency of unrecognized mental disorders in HCV-infected patients. Gen Hosp Psychiatry. 2008;30:80–82.
  6. Martin-Thormeyer EM, Paul RH. Drug abuse and hepatitis C Infection as comorbid features of HIV associated neurocognitive disorder: Neu-rocognitive and neuroimaging features. Neuropsychol Rev. 2009;19:215–231.
  7. Sylvestre DL, Loftis JM, Hauser P, et al. Co-occurring hepatitis C, substance use, and psychiatric illness: Treatment issues and developing integrated models of care. J Urban Health. 2004;81(4):719–734.
  8. Forton DM, Taylor-Robinson SD, Thomas HC. Cerebral dysfunction in chronic hepatitis C infection. J Viral Hepat. 2003;10:81–85.
  9. Dróżdż W, Borkowska A, Wikłość M, et al. Chronic psychotic disorders and dementia in a patient with chronic hepatitis C as a consequence of therapy with pegylated interferon-alpha and ribavirin. Case study. Farmakoter Psychiatr Neurol. 2006;2:87–92.
  10. Pawłowski T, Małyszczak K, Inglot M, et al. Depressive symptoms in patients with chronic hepatitis C. Post Psychiatr Neurol. 2006;15(2):67–70.
  11. Dinwiddie SH, Shicker L, Newman T. Prevalence of hepatitis C among psychiatric patients in the public sector. Am J Psychiatry. 2003;160(1):172–174.
  12. Loftis JM, Matthews AM, Hauser P. Psychiatric and substance use disorders in individuals with hepatitis C epidemiology and management. Drugs. 2006;66(2):155–174.
  13. Himelhoch S, McCarthy JF, Ganoczy D, et al. Understanding associations between serious mental illness and hepatitis C virus among veter-ans: A national multivariate analysis. Psychosomatics. 2009;50:30–37.
  14. Navines R, Castellvi P, Moreno-Espana J, et al. Depressive and anxiety disorders in chronic hepatitis C patients: Reliability and validity of the patient health questionnaire. J Affect Disord. 2012;138(3):343–351.
  15. Pawłowski T, Małyszczak K, Inglot M, et al. Neuropsychiatric symptoms of chronic hepatitis C. Post Psychiatr Neurol. 2005;14(4):337–342.
  16. Swain MG, Maric M. Defective corticotropin-releasing hormone mediated neuroendocrine and behavioral responses in cholestatic rats: Implications for cholestatic liver disease-related sickness behaviors. Hepatology. 1995;22:1560–1564.
  17. Peixoto B, Lopez L, Areias J, et al. Executive functions In chronic hepatitis C virus-infected patients. Adv Clin Exp Med. 2008;17(1):53–60.
  18. Lehman CL, Cheung RC. Depression, anxiety, post-traumatic stress and alcohol-related problems among veterans with chronic hepatitis C. Am J Gastroenterol. 2002;97(10):2640–2646.
  19. Czarnecki M, Inglot M, Małyszczak K, et al. Neuropsychiatric disorders among HCV infected patients – own observations. Przegl Epidemiol. 2005;59:431–438.
  20. McCarthy JJ, Flynn N. Hepatitis C in methadone maintenance patients: Prevalence an public policy implications. J Addict Dis. 2001;20:19–31.
  21. El-Serag HB, Kunik M, Richardson P, et al. Psychiatric disorders among veterans with hepatitis C infection. Gastroenterology. 2002; 123(2):476–482.
  22. Hatem C, Minello A, Bresson-Hadni S, et al. Is the management of hepatitis C patients appropriate? A population-based study. Aliment Phar-macol Ther. 2005;21(8):1007–1015.
  23. Sylvestre DL. Treating hepatitis C virus infection in active substance users. Clin Infect Dis. 2005; 40:321–324.
  24. Sylvestre DL. Treating hepatitis C in methadone maintenance patients: An interim analysis. Drug Alcohol Depend. 2002;67:117–123.
  25. Appendix no. 47 of the Law no. 59/2011/DGL President of NFZ, 10.10.2011
  26. WHO ASSIST Working Group. The WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Development, reliability and feasibility. Addiction. 2002;97:1183–1194.
  27. Rifai MA, Indest D, Loftis J, et al. Psychiatric management of the hepatitis C patient. Curr Treat Options Gastroenterol. 2006;9(6):508–519.
  28. Weissenborn K, Krause J, Bokemeyer M, et al. Hepatitis C virus infection affects the brain-evidence from psychometric studies and magnetic resonance spectroscopy. J Hepatol. 2004;41:845–851.
  29. Murray J, Fishman SL, Ryan E, et al. Clinicopathologic correlates of hepatitis C virus in brain: A pilot study. J Neurovirol. 2008;14(1);17–27.
  30. Fontana RJ, Bieliauskas LA, Back-Madruga C, et al. The HALT-C Trial Group. Cognitive function in hepatitis C patients with advanced fibrosis enrolled in the HALT-C trial. J Hepatol. 2005;43:614–622.
  31. Dróżdż W, Halota W, Palewicz E, et al. Cognitive functions disorders in patients with chronic hepatitis C. Neuropsychiatr Neuropsychol. 2008;3(3–4):126–132.
  32. Forton DM, Karayiannis P, Mahmud N. Identification of unique hepatitis C virus quasispecies in the central nervous system and comparative analysis of internal translational efficiency of brain, liver and serum variants. J Virol. 2004;78:5170–5183,
  33. Fishman SL, Murray JM, Eng FJ, et al. Molecular and bioinformatic evidence of hepatitis C virus evolution in brain. J Infect Dis. 2008;197:597–607.
  34. Fletcher NF, Wilson GK, Murray J, et al. Hepatitis C virus infects the endothelial cells of the blood–brain barrier. Gastroenterology, 2012;142(3):634–643.
  35. Jones EA. Relief from profound fatigue associated with chronic liver disease by long-term ondansetron therapy. Lancet. 1999;354:397.
  36. Thames AD, Castellon SA, Singer EJ, et al. Neuroimaging abnormalities, neurocognitive function and fatigue in patients with hepatitis C. Neurol Neuroimmunol Neuroinflamm. 2015;2(1):e59.
  37. Kramer L, Bauer E, Funk G, et al. Subclinical impairment of brain function in chronic hepatitis C infection. J Hepatol. 2002;37:349–354.
  38. Bladowska J, Knysz B, Zimny A, et al. Value of perfusion-weighted MR imaging in the assessment of early cerebral alterations in neurologi-cally asymptomatic HIV-1-positive and HCV-positive patients. PLoS One. 2014;9(7):e102214.
  39. Bladowska J, Zimny A, Knysz B, et al. Evaluation of early cerebral metabolic, perfusion and microstructural changes in HCV-positive patients: A pilot study. J Hepatol. 2013;59(4):651–657.
  40. Pawełczyk T, Pawełczyk A, Białkowska J, et al. Cognitive disturbances observed in chronic hepatitis C patients during pegylated interferon alpha and ribavirin therapy. Psychiatr Pol. 2008;42(6):925–941.
  41. Lieb K, Engelbrecht MA, Gut O, et al. Cognitive impairment in patients with chronic hepatitis treated with interferon alpha (IFNa): Results from a prospective study. Eur Psychiatry. 2006;21:204–210.
  42. Schaefer M, Hinzpeter A, Mohmand A, et al. Hepatitis C treatment in “difficult-to-treat” psychiatric patients with pegylated interferon-alpha and ribavirin: Response and psychiatric side effects. Hepatology. 2007;46(4):991–998.
  43. Alexopoulou A, Karayiannis P. Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals. Ann Gastroenterol. 2015;28(1):55–65.
  44. Sockalingam S, Tseng A, Giguere P, et al. Psychiatric treatment considerations with direct acting antivirals in hepatitis C. BMC Gastroenterol. 2013;13:86.
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