Hepatitis C virus antibody titers associated with cognitive dysfunction in an asymptomatic community-based sample
Ibrahim, I., Salah, H., El Sayed, H., Mansour, H., Eissa, A., Wood, J., Fathi, W., Tobar, S., Gur, R. C., Gur, R. E., Dickerson, F., Yolken, R. H., El Bahaey, W., Nimgaonkar, V.
Journal of Clinical and Experimental Neuropsychology 2016; 38: 861-868
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Background: Hepatitis C virus (HCV) infection is associated with cognitive dysfunction in clinic-based studies. The risk could be attributed to factors such as antiviral medications, substance abuse, or coincidental infection. Aim: The aim was to evaluate cognitive function in relation to HCV antibody titers in a community-based sample of asymptomatic individuals at low risk for substance abuse. Method: Adults were ascertained from a community in Mansoura, Egypt, where HCV is endemic (n = 258). Cognitive performance was evaluated using the Arabic version of the Penn Computerized Neurocognitive Battery. Substance abuse and psychopathology were also assessed. Antibodies to HCV and Toxoplasma gondii (TOX), a common protozoan that can affect cognition, were estimated using serological IgG assays. Results: The prevalence of HCV and TOX infection was 17.6% and 52.9%, respectively. HCV antibody titers were significantly associated with worse function in four cognitive tests for accuracy and three tests for speed, after adjusting for covariates (p <.05, beta coefficients, 2.1-3.2). TOX antibody titers were associated with impaired accuracy in one test. Conclusions: The association between HCV antibody titers and cognitive impairment is not mediated by antiviral treatment or substance abuse in this sample. Whether HCV has a causal role in the cognitive dysfunction should be investigated.