Antiviral Treatment and Response are Associated With Lower Risk of Dementia Among Hepatitis C Virus-Infected Patients

Authors

Meng-Hua Tao, Henry Ford HealthFollow
Stuart C. Gordon, Henry Ford HealthFollow
Trueman Wu, Henry Ford HealthFollow
Sheri Trudeau, Henry Ford HealthFollow
Loralee B. Rupp, Henry Ford HealthFollow
Humberto C. Gonzalez, Henry Ford HealthFollow
Yihe G. Daida
Mark A. Schmidt
Mei Lu, Henry Ford HealthFollow

Recommended Citation

Tao MH, Gordon S, Wu T, Trudeau S, Rupp LB, Gonzalez HC, Daida YG, Schmidt MA, and Lu M. Antiviral Treatment and Response are Associated With Lower Risk of Dementia Among Hepatitis C Virus-Infected Patients. Am J Geriatr Psychiatry 2023.

Document Type

Article

Publication Date

5-1-2024

Publication Title

The American journal of geriatric psychiatry

Abstract

OBJECTIVE: Eradication of hepatitis C virus (HCV) infection has been linked with improvement in neurocognitive function, but few studies have evaluated the effect of antiviral treatment/ response on risk of dementia. Using data from the Chronic Hepatitis Cohort Study (CHeCS), we investigated how antiviral therapy impacts the risk of developing dementia among patients with HCV.

METHODS: A total of 17,485 HCV patients were followed until incidence of dementia, death, or last follow-up. We used an extended landmark modeling approach, which included time-varying covariates and propensity score justification for treatment selection bias, as well as generalized estimating equations (GEE) with a link function as multinominal distribution for a discrete time-to-event data. Death was considered a competing risk.

RESULTS: After 15 years of follow-up, 342 patients were diagnosed with incident dementia. Patients who achieved sustained virological response (SVR) had significantly decreased risk of dementia compared to untreated patients, with hazard ratios (HRs) of 0.32 (95% CI 0.22-0.46) among patients who received direct-acting antiviral (DAA) treatment and 0.41 (95% CI 0.26-0.60) for interferon-based (IFN) treatment. Risk reduction remained even when patients failed antiviral treatment (HR 0.38, 95% CI 0.38-0.51). Patients with cirrhosis, Black/African American patients, and those without private insurance were at significantly higher risk of dementia.

CONCLUSION: Antiviral treatment independently reduced the risk of dementia among HCV patients, regardless of cirrhosis. Our findings support the importance of initiation antiviral therapy in chronic HCV-infected patients.

Medical Subject Headings

Humans; Antiviral Agents; Hepacivirus; Cohort Studies; Hepatitis C, Chronic; Hepatitis C; Liver Cirrhosis; Dementia

PubMed ID

38199936

ePublication

ePub ahead of print

Volume

32

Issue

5

First Page

611

Last Page

621