Generic placeholder image

Current Drug Therapy

Editor-in-Chief

ISSN (Print): 1574-8855
ISSN (Online): 2212-3903

Systematic Review Article

Neurocognitive Changes in Chronic Hepatitis C Patients Receiving Combination Therapy of Interferon and Ribavirin: A Systematic Review

Author(s): Momin Altaf Wani, Nidhi B. Agarwal, Yasmeen and Mohd Ashif Khan*

Volume 17, Issue 5, 2022

Published on: 15 August, 2022

Page: [349 - 358] Pages: 10

DOI: 10.2174/1574885517666220617124629

Price: $65

Abstract

Background: Approximately 3% of the world’s total population is affected by the Hepatitis C virus (HCV). The treatment for HCV differs widely across countries, and one of the therapies used is the combination of interferon (INF) and ribavirin (RBV). Few studies have shown that this combination increases the rate of sustained virological response in HCV patients, resulting in beneficial effects on cognition, while other studies report that it leads to cognitive decline. Thus, this systematic review aims to assess the effects of INF+RBV therapy on neurocognitive changes in HCV patients.

Methods: Studies reporting the effect of INF+RBV on neurocognitive changes were searched using Scopus, PubMed, Academia, Google Scholar, Science Direct, and Cochrane. The studies were retrieved till August 23, 2021. The quality assessment of the included studies was done using Cochrane’s bias assessment tool.

Results: A total of 6380 articles were found in the initial search. After removing the duplicates, 619 articles were screened on the basis of titles. Further, after the screening, 54 articles were screened on the basis of abstract, and finally, 16 articles were included in this study. Nine studies reported a decline in cognitive function post-INF+RBV therapy, while 7 articles reported improvement in cognitive functions.

Conclusion: In conclusion, the combination therapy of INF and RBV may result in cognitive decline in HCV patients.

Keywords: Hepatitis C, interferon, ribavirin, cognition, cognitive impairment, neuropsychological aspects.

Graphical Abstract

[1]
National institutes of health consensus development conference statement: Management of hepatitis C 2002 (June 10-12, 2002). Gastroenterology 2002; 123(6): 2082-99.
[http://dx.doi.org/10.1053/gast.2002.1232082] [PMID: 12454863]
[2]
Palumbo E. Pegylated interferon and ribavirin treatment for hepatitis C virus infection. Ther Adv Chronic Dis 2011; 2(1): 39-45.
[http://dx.doi.org/10.1177/2040622310384308] [PMID: 23251740]
[3]
Pearlman BL, Traub N. Sustained virologic response to antiviral therapy for chronic hepatitis C virus infection: A cure and so much more. Clin Infect Dis 2011; 52(7): 889-900.
[http://dx.doi.org/10.1093/cid/cir076] [PMID: 21427396]
[4]
Hoofnagle JH, Seeff LB. Peginterferon and ribavirin for chronic hepatitis C. N Engl J Med 2006; 355(23): 2444-51.
[http://dx.doi.org/10.1056/NEJMct061675] [PMID: 17151366]
[5]
Feld JJ, Hoofnagle JH. Mechanism of action of interferon and ribavirin in treatment of hepatitis C. Nature 2005; 436(7053): 967-72.
[http://dx.doi.org/10.1038/nature04082] [PMID: 16107837]
[6]
Glue P. The clinical pharmacology of ribavirin. Semin Liver Dis 1999; 19 (Suppl. 1): 17-24.
[PMID: 10349689]
[7]
Hassaan SH, Darwish AM, Khalifa H, et al. Assessment of cognitive functions and psychiatric symptoms in hepatitis C patients receiving pegylated interferon alpha and ribavirin: A prospective cohort study. Int J Psychiatry Med 2019; 54(6): 424-40.
[http://dx.doi.org/10.1177/0091217419858277] [PMID: 31219366]
[8]
Tanaka H, Sasaki H. Cognitive impairment with interferon treatment in patients with chronic hepatitis C. Biomed Res 2017; 38(6): 371-4.
[http://dx.doi.org/10.2220/biomedres.38.371] [PMID: 29225215]
[9]
Ashtary-Larky D, Bagheri R, Abbasnezhad A, Tinsley GM, Alipour M, Wong A. Effects of gradual weight loss v. rapid weight loss on body composition and RMR: A systematic review and meta-analysis. Br J Nutr 2020; 124(11): 1121-32.
[http://dx.doi.org/10.1017/S000711452000224X] [PMID: 32576318]
[10]
el Meguid MA, Moussa MP. 1.g. 006 cognitive function in hepatitis C patients: Effect of pegylated interferon a and ribavirin therapy. Eur Neuropsychopharmacol 2010; 20(2): S311-2.
[http://dx.doi.org/10.1016/S0924-977X(10)70419-3]
[11]
Barbosa MED, Zaninotto AL, de Campos Mazo DF, et al. Hepatitis C virus eradication improves immediate and delayed episodic memory in patients treated with interferon and ribavirin. BMC Gastroenterol 2017; 17(1): 122.
[http://dx.doi.org/10.1186/s12876-017-0679-5] [PMID: 29178838]
[12]
Byrnes V, Miller A, Lowry D, et al. Effects of anti-viral therapy and HCV clearance on cerebral metabolism and cognition. J Hepatol 2012; 56(3): 549-56.
[http://dx.doi.org/10.1016/j.jhep.2011.09.015] [PMID: 22027578]
[13]
Fontana RJ, Bieliauskas LA, Lindsay KL, et al. Cognitive function does not worsen during pegylated interferon and ribavirin retreatment of chronic hepatitis C. Hepatology 2007; 45(5): 1154-63.
[http://dx.doi.org/10.1002/hep.21633] [PMID: 17465000]
[14]
Miller TR, Weiss JJ, Bräu N, Dieterich DT, Stivala A, Rivera-Mindt M. Greater decline in memory and global neurocognitive function in HIV/hepatitis C co-infected than in hepatitis C mono-infected patients treated with pegylated interferon and ribavirin. J Neurovirol 2017; 23(2): 260-72.
[http://dx.doi.org/10.1007/s13365-016-0494-8] [PMID: 27896573]
[15]
Cattie JE, Letendre SL, Woods SP, et al. Persistent neurocognitive decline in a clinic sample of hepatitis C virus-infected persons receiving interferon and ribavirin treatment. J Neurovirol 2014; 20(6): 561-70.
[http://dx.doi.org/10.1007/s13365-014-0265-3] [PMID: 25326107]
[16]
Reichenberg A, Gorman JM, Dieterich DT. Interferon-induced depression and cognitive impairment in hepatitis C virus patients: A 72 week prospective study. AIDS 2005; 19 (Suppl. 3): S174-8.
[http://dx.doi.org/10.1097/01.aids.0000192087.64432.ae] [PMID: 16251815]
[17]
McNutt MD, Liu S, Manatunga A, et al. Neurobehavioral effects of interferon-α in patients with hepatitis-C: Symptom dimensions and responsiveness to paroxetine. Neuropsychopharmacology 2012; 37(6): 1444-54.
[http://dx.doi.org/10.1038/npp.2011.330] [PMID: 22353759]
[18]
Pawelczyk T, Pawelczyk A, Strzelecki D, Rabe-Jablonska J. Pegylated interferon α and ribavirin therapy may induce working memory disturbances in chronic hepatitis C patients. Gen Hosp Psychiatry 2008; 30(6): 501-8.
[http://dx.doi.org/10.1016/j.genhosppsych.2008.03.001] [PMID: 19061675]
[19]
Kraus MR, Schäfer A, Wissmann S, Reimer P, Scheurlen M. Neurocognitive changes in patients with hepatitis C receiving interferon alfa-2b and ribavirin. Clin Pharmacol Ther 2005; 77(1): 90-100.
[http://dx.doi.org/10.1016/j.clpt.2004.09.007] [PMID: 15637534]
[20]
Nesić Z, Delić D, Prostran M, Stojanović R, Vucković S, Todorović Z. Psychiatric adverse effects induced by recombinant interferon alfa in patients with chronic hepatitis C. Med Pregl 2004; 57(5-6): 219-26.
[http://dx.doi.org/10.2298/MPNS0406219N] [PMID: 15503789]
[21]
Thein HH, Maruff P, Krahn MD, et al. Improved cognitive function as a consequence of hepatitis C virus treatment. HIV Med 2007; 8(8): 520-8.
[http://dx.doi.org/10.1111/j.1468-1293.2007.00505.x] [PMID: 17944685]
[22]
Kraus MR, Schäfer A, Teuber G, et al. Improvement of neurocognitive function in responders to an antiviral therapy for chronic hepatitis C. Hepatology 2013; 58(2): 497-504.
[http://dx.doi.org/10.1002/hep.26229] [PMID: 23300053]
[23]
Drózdz W, Borkowska A, Halota W, Rybakowski JK. Depressive symptoms and cognitive dysfunction in patients with hepatitis C treated with interferon-α and ribavirine. Arch Psychiatry Psychother 2008; 10(1): 85-91.
[24]
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): 925-41.
[PMID: 19441669]
[25]
Haj-Sheykholeslami A, Keshvari M, Sharafi H, Pouryasin A, Hemmati K, Mohammadzadehparjikolaei F. Interferon-λ polymorphisms and response to pegylated interferon in Iranian hepatitis C patients. World J Gastroenterol 2015; 21(29): 8935-42.
[http://dx.doi.org/10.3748/wjg.v21.i29.8935] [PMID: 26269684]
[26]
Behnava B, Sharafi H, Keshvari M, et al. The role of polymorphisms near the IL28B gene on response to peg-interferon and ribavirin in thalassemic patients with hepatitis C. Hepat Mon 2016; 16(1): e32703.
[http://dx.doi.org/10.5812/hepatmon.32703] [PMID: 27110259]
[27]
Wichers MC, Maes M. The role of indoleamine 2,3-dioxygenase (IDO) in the pathophysiology of interferon-α-induced depression. J Psychiatry Neurosci 2004; 29(1): 11-7.
[PMID: 14719046]
[28]
Tanaka H, Maeshima S, Shigekawa Y, et al. Neuropsychological impairment and decreased regional cerebral blood flow by interferon treatment in patients with chronic hepatitis: A preliminary study. Clin Exp Med 2006; 6(3): 124-8.
[http://dx.doi.org/10.1007/s10238-006-0107-6] [PMID: 17061061]
[29]
Juengling FD, Ebert D, Gut O, et al. Prefrontal cortical hypometabolism during low-dose interferon alpha treatment. Psychopharmacology (Berl) 2000; 152(4): 383-9.
[http://dx.doi.org/10.1007/s002130000549] [PMID: 11140330]
[30]
Meyers CA, Scheibel RS, Forman AD. Persistent neurotoxicity of systemically administered interferon-alpha. Neurology 1991; 41(5): 672-6.
[http://dx.doi.org/10.1212/WNL.41.5.672] [PMID: 2027482]
[31]
Pavol MA, Meyers CA, Rexer JL, Valentine AD, Mattis PJ, Talpaz M. Pattern of neurobehavioral deficits associated with interferon alfa therapy for leukemia. Neurology 1995; 45(5): 947-50.
[http://dx.doi.org/10.1212/WNL.45.5.947] [PMID: 7746412]
[32]
Yirmiya R, Weidenfeld J, Pollak Y, et al. Cytokines, “depression due to a general medical condition,” and antidepressant drugs. Adv Exp Med Biol 1999; 461: 283-316.
[http://dx.doi.org/10.1007/978-0-585-37970-8_16] [PMID: 10442179]
[33]
Kamata M, Higuchi H, Yoshimoto M, et al. Effect of single intracerebroventricular injection of alpha-interferon on monoamine concentrations in the rat brain. Eur Neuropsychopharmacol 2000; 10: 129-32.
[http://dx.doi.org/10.1016/S0924-977X(99)00067-X] [PMID: 10706995]
[34]
Shuto H, Kataoka Y, Horikawa T, Fujihara N, Oishi R. Repeated interferon-alpha administration inhibits dopaminergic neural activity in the mouse brain. Brain Res 1997; 747(2): 348-51.
[http://dx.doi.org/10.1016/S0006-8993(96)01371-6] [PMID: 9046014]
[35]
Capuron L, Schroecksnadel S, Féart C, et al. Chronic low-grade inflammation in elderly persons is associated with altered tryptophan and tyrosine metabolism: Role in neuropsychiatric symptoms. Biol Psychiatry 2011; 70(2): 175-82.
[http://dx.doi.org/10.1016/j.biopsych.2010.12.006] [PMID: 21277567]
[36]
Widner B, Ledochowski M, Fuchs D. Interferon-gamma-induced tryptophan degradation: Neuropsychiatric and immunological consequences. Curr Drug Metab 2000; 1(2): 193-204.
[http://dx.doi.org/10.2174/1389200003339063] [PMID: 11465083]
[37]
Byrne GI, Lehmann LK, Kirschbaum JG, Borden EC, Lee CM, Brown RR. Induction of tryptophan degradation in vitro and in vivo: A γ-interferon-stimulated activity. J Interferon Res 1986; 6(4): 389-96.
[http://dx.doi.org/10.1089/jir.1986.6.389] [PMID: 3095441]
[38]
Brown RR, Ozaki Y, Datta SP, Borden EC, Sondel PM, Malone DG. Implications of interferon-induced tryptophan catabolism in cancer, auto-immune diseases and AIDS. Adv Exp Med Biol 1991; 294: 425-35.
[http://dx.doi.org/10.1007/978-1-4684-5952-4_39] [PMID: 1722946]
[39]
Morikawa O, Sakai N, Obara H, Saito N. Effects of interferon-alpha, interferon-gamma and cAMP on the transcriptional regulation of the serotonin transporter. Eur J Pharmacol 1998; 349(2-3): 317-24.
[http://dx.doi.org/10.1016/S0014-2999(98)00187-3] [PMID: 9671113]
[40]
Organization WH. Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection, 2018. Available from: https://www.who.int/publications-detail-redirect/9789241550345
[41]
da Fonseca EM, Shadlen K, Bastos FI. Brazil’s fight against hepatitis C - universalism, local production, and patents. N Engl J Med 2019; 380(7): 605-7.
[http://dx.doi.org/10.1056/NEJMp1812959] [PMID: 30763192]
[42]
Pecoraro V, Banzi R, Cariani E, et al. New direct-acting antivirals for the treatment of patients with hepatitis C virus infection: A systematic review of randomized controlled trials. J Clin Exp Hepatol 2019; 9(4): 522-38.
[http://dx.doi.org/10.1016/j.jceh.2018.07.004] [PMID: 31516269]
[43]
Santos-Lima C, Souza-Marques B, Vieira F, Isabel Schinoni M, Quarantini LC, Abreu N. Neuropsychological effects of direct-acting antiviral treatment for Hepatitis C virus subjects: A systematic review. J Viral Hepat 2021; 28(12): 1672-82.
[http://dx.doi.org/10.1111/jvh.13584] [PMID: 34320255]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy