[Cognitive disturbances observed in chronic hepatitis C patients during pegylated interferon alpha and ribavirin therapy]. / Zaburzenia procesów poznawczych obserwowane u pacjentów z przewleklym zapaleniem watroby typu C w trakcie terapii pegylowanym interferonem alfa i rybawirynq.

UNLABELLED: Chronic hepatitis C (CHC) patients treated with peg-interferon alpha and ribavirin (peg-IFNalpha/RBV) complain of irritability, attention and memory disturbances which may indicate cognitive impairment associated with treatment. AIM: Assessment of the probable connection between peg-IFNalpha/RBV treatment and the development of cognitive disturbances in CHC patients. METHOD: 47 CHC patients were divided into two groups: experimental (n=26) and control (n=21). The experimental group patients were given peg-IFNalpha2a (n=18) or peg-IFNalpha2b (n=8) plus RBV in standard doses as recommended by the manufacturers. Control group patients did not receive the above treatment. Both groups underwent a neuropsychological examination consisting of R. Brickenkamp d2 test, Auditory Verbal Learning Test and Hooper Visual Organization Test at the beginning (t=0) and after 12 weeks of treatment or observation (t=1). RESULTS: The experimental group patients showed significant deterioration in all the measured cognitive functions in t=1 comparing to t=0. Cognitive decline was not seen in the control group. The observed cognitive performance changes could not be correlated sufficiently enough with the presence of organic affective disorders diagnosed according to ICD-10 criteria. CONCLUSIONS: The findings suggest that peg-IFNalpha/RBV therapy of CHC patients is connected with the deterioration in cognitive functioning including attention, auditory verbal memory and visuo-spatial skills. These changes may be the effect of peg-IFNalpha-induced neurotransmission abnormalities in the dorso-lateral prefrontal cortex, anterior cingulate cortex, hippocampus and parieto-orbital cortical regions and can impair patients' ability to drive a motor vehicle, operate machinery, or their engagement in hazardous activities requiring attention and coordination. Medical professionals should thoroughly inform patients about the possibility of cognitive decline associated with peg-IFNalpha/RBV therapy.

[Attention abnormalities in patients with chronic hepatitis C after pegylated interferon alpha and ribavirin treatment]. / Zaburzenia uwagi utrzymujace sie u chorych na przewlekle zapalenie watroby typu C po zakonczeniu leczenia pegylowanym interferonem alfa i rybawiryna.

THE AIM OF THE STUDY: To (a) describe the influence of peg-IFNalpha 2a and 2b on attention processes and (b) to assess whether attention abnormalities induced by peg-IFNalpha/RBW resolve 8 weeks after treatment discontinuation in chronic hepatitis C patients. MATERIAL AND METHODS: 26 chronic hepatitis C patients treated with peg-IFNalpha2a (n=18) or 2b (n=8) and RBV were enrolled in the study. Attention processes were tested three times: before the beginning (t=0), after 12 weeks of medication (t=1) and 8 weeks after treatment discontinuation (t=2). Attention was assessed with Brickenkamp d2 test and the results were compared in groups of patients treated with different kinds of peg-IFNalpha. RESULTS: The two kinds of peg-IFNalpha did not differ significantly regarding the influence on attention processes. 8 weeks after treatment discontinuation (t=2) there was observed a significant decrease all aspects of attention measured by d2 test, i.e. work accuracy, speed of processing and ability to focus attention comparing with t=0 and t=1. CONCLUSIONS: Peg-IFNalpha/RBW therapy is connected with a decrease in attention processes performance and the two kinds of peg-interferon alpha (2a and 2b) may exert a similar influence. Attention dysfunction did not resolve 8 weeks after treatment discontinuation and may be the irreversible effect of the dorso-lateral prefrontal cortex or anterior cingulate cortex damage.