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Hepatitis C virus-related factors associated WITH cognitive performance in HIV-HCV-coinfected patients.
Journal of Neurovirology ( IF 3.2 ) Pub Date : 2019-07-07 , DOI: 10.1007/s13365-019-00780-9
Massimiliano Fabbiani 1 , Nicoletta Ciccarelli 2 , Valeria Castelli 3 , Alessandro Soria 3 , Alberto Borghetti 4 , Elisa Colella 3 , Davide Moschese 4 , Manuela Valsecchi 3 , Arianna Emiliozzi 4 , Andrea Gori 3 , Andrea De Luca 5 , Alessandra Bandera 3 , Simona Di Giambenedetto 4
Affiliation  

The contribution of HCV-related variables to cognitive impairment in HIV-HCV-coinfected patients has been poorly investigated. We selected HIV-HCV-coinfected patients undergoing cognitive examination (exploring memory, language, speed of mental processing and fine motor function) at three clinical centres. Cognitive performance was evaluated using Z-transformed scores. Logistic regression analysis was used to investigate variables associated to cognitive impairment (defined as a composite Z-score ≤ - 1). Overall, 146 HIV-HCV-coinfected patients were enrolled. Median HCV-RNA was 6.2logU/mL. HCV genotype 1a/b was the most represented (53.4%). Liver fibrosis was mild (Fib4 ≤ 1.45) in the majority of patients (44.5%). Global cognitive impairment was diagnosed in 35 (24%) subjects. Exploring each domain, a higher proportion of impairment was observed for memory (37%) followed by speed of mental processing (32.2%), fine motor functioning (24%) and language (18.5%). Among HCV-related variables, the duration of HCV infection was independently associated with global cognitive impairment (aOR 1.13 per +1 year, p = 0.016) and abnormal speed of mental processing (aOR 1.16 per +1 year, p = 0.001), while higher HCV-RNA was independently associated to fine motor functioning impairment (aOR 1.98 per +1log, p = 0.037). HCV genotype, fibrosis stage, transaminases or bilirubin levels were not related to cognitive performance. Of note, integrase inhibitor (InSTI) use was independently associated to a pathological performance in fine motor functioning (aOR 3.34, p = 0.035) and memory (aOR 3.70, p = 0.014). In conclusion, the duration of HCV infection and HCV-RNA load showed an association with cognitive impairment, suggesting a role of hepatitis-related factors in the development of cognitive disorders in HIV-HCV-coinfected patients. The association between InSTI use and altered cognitive performance should prompt investigations about potential neurotoxicity of these drugs.

中文翻译:

丙型肝炎病毒相关因素与HIV-HCV合并感染患者的认知表现有关。

HCV相关变量对HIV-HCV合并感染患者认知功能障碍的影响研究很少。我们选择在三个临床中心接受HIV-HCV感染的患者进行认知检查(探索记忆力,语言,心理加工速度和精细运动功能)。使用Z转换得分评估认知能力。使用逻辑回归分析研究与认知障碍相关的变量(定义为复合Z分数≤-1)。总共招募了146名HIV-HCV合并感染的患者。HCV-RNA中位数为6.2logU / mL。HCV基因型1a / b代表最多(53.4%)。大多数患者(44.5%)的肝纤维化为轻度(Fib4≤1.45)。在35(24%)位受试者中诊断出整体认知障碍。探索每个领域,记忆障碍的比例更高(37%),其次是心理处理速度(32.2%),精细运动功能(24%)和语言障碍(18.5%)。在与HCV相关的变量中,HCV感染的持续时间与整体认知障碍(每+1年的aOR 1.13,p = 0.016)和精神加工的异常速度(每+1年的aOR 1.16,p = 0.001)独立相关,而较高的HCV-RNA独立地与精细运动功能障碍相关(aOR 1.98 / + 1log,p = 0.037)。HCV基因型,纤维化分期,转氨酶或胆红素水平与认知能力无关。值得注意的是,整合酶抑制剂(InSTI)的使用与精细运动功能(aOR 3.34,p = 0.035)和记忆(aOR 3.70,p = 0.014)的病理表现独立相关。结论,HCV感染的持续时间和HCV-RNA负荷与认知功能障碍相关,这表明在感染HIV-HCV的患者中,肝炎相关因素在认知功能障碍的发展中具有重要作用。InSTI使用与认知功能改变之间的关联应促使人们对这些药物的潜在神经毒性进行调查。
更新日期:2019-11-01
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