The effects of hepatitis C, HIV, and methamphetamine dependence on neuropsychological performance: biological correlates of disease
The effects of hepatitis C, HIV, and methamphetamine dependence on neuropsychological performance: biological correlates of disease
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DOI：
10.1097/01.aids.0000192073.18691.ff
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发表时间：
2005-10-01
期刊：
影响因子：
3.8
通讯作者：
Grant, I
中科院分区：
文献类型：
--
作者：
Letendre, SL;Cherner, M;Grant, I
目的：为了确定丙型肝炎病毒（HCV）感染对神经心理（NP）performance.Design的影响：前瞻性招募cohol.Methods的横断面分析：共239 HIV血清阳性和287 HIV血清阴性的受试者在一个单一的中心参加前瞻性队列研究。受试者接受标准化评估，包括综合神经心理学测试、物质使用清单神经医学检查、静脉穿刺和腰椎穿刺。检测血清中HCV抗体。在血清阳性的个人，HCV RNA测定血浆和脑脊液（CSF）。结果：HCV血清阳性的受试者进行更糟糕的神经心理测试，几乎两倍的可能性被诊断为全球受损，与那些谁是HCV血清阴性。在多变量分析中，HCV、HIV和甲基苯丙胺依赖与较差的表现独立相关，即使在调整了疾病控制中心的分期和抗逆转录病毒药物使用后。血浆中HCVRNA水平在那些记忆力受损的人中更高，但不是全局性的。脑脊液中HCV RNA均低于100拷贝/ml。在HIV感染的受试者中，HCV与CSF中较高水平的HIV RNA相关，但与血浆中的HIV RNA无关。HCV还与较高水平的单核细胞趋化蛋白1、TNF-α和可溶性TNF受体II相关。HCV血清阳性受试者似乎没有晚期肝病。结论：HIV，HCV和甲基苯丙胺独立损伤中枢神经系统，导致全球神经心理障碍。HCV可通过病毒或免疫介导的机制损伤大脑。HCV相关的脑损伤可能是可预防的或可逆的，因为HCV感染是潜在的可治愈的。(c)2005年利平科特威廉姆斯&威尔金斯。
Objective: To determine the effects of hepatitis C virus (HCV) infection on neuropsychological (NP) performance.Design: Cross-sectional analysis of a prospectively enrolled cohort.Methods: A total of 239 HIV-seropositive and 287 HIV-seronegative subjects enrolled in prospective cohort studies at a single center. Subjects underwent standardized assessments, including comprehensive neuropsychological testing, substance use inventory neuromedical examination, venipuncture, and lumbar puncture. HCV antibody was measured in serum. In seropositive individuals, HCV RNA was measured in plasma and cerebrospinal fluid (CSF).Results: HCV-seropositive subjects performed worse on neuropsychological testing and were almost twice as likely to be diagnosed as globally impaired, compared with those who were HCV seronegative. In a multivariate analysis, HCV, HIV, and methamphetamine dependence were independently associated with worse performance, even after adjusting for Centers for Disease Control stage and antiretroviral use. HCVRNA levels in plasma were higher in those with memory, but not global, impairment. In cerebrospinal fluid, HCV RNA was below 100 copies/ml in all specimens. In HIV-infected subjects, HCV was associated with higher levels of HIV RNA in CSF, but not in plasma. HCV was also associated with higher levels of monocyte chemotactic protein 1, TNF-alpha, and soluble TNF receptor II. HCV-seropositive subjects did not appear to have advanced liver disease.onclusions: HIV, HCV, and methamphetamine independently injure the central nervous system, leading to global neuropsychological impairment. HCV may injure the brain by viral or immune-mediated mechanisms. HCV-associated brain injury may be preventable or reversible because HCV infection is potentially curable. (c) 2005 Lippincott Williams & Wilkins.