Effect of interferon-free therapy on cognition in HCV and HCV/HIV infection: A pilot study

Approval of direct-acting antivirals against the hepatitis C virus (HCV) has dramatically changed the management of HCV infection due to high cure rates and a favorable safety profile. Their influence on neurologic aspects is notably relevant, as studies demonstrated active HCV replication within the CNS1 and alterations in cerebral metabolism consistent with neuroinflammatory conditions.2 These findings may be causative for cognitive deficits in HCV-infected patients.3 Similar impairment has been demonstrated in patients coinfected with HIV, with a prevalence as high as 60%.4 Therefore, these patients may particularly benefit from HCV eradication. To date, studies addressing the issue of reversibility of cognitive deficits after HCV therapy are based on interferon treatment, which itself can cause continuing cognitive impairment.5 The important question whether these deficits are indeed reversible after HCV eradication remains unsolved to date. Acknowledgment: The authors thank Ute Kopp for neuropsychological advice.