MODERN CONCEPTS OF THE ROLE OF CHRONIC VIRAL HEPATITIS IN THE DEVELOPMENT OF COGNITIVE IMPAIRMENT
Introduction In recent decades, studies have shown that in chronic viral hepatitis there is a wide range of extrahepatic manifestations associated with viral replication both in the liver and outside it, which leads to damage to various organs. Cognitive dysfunction is associated with both a violation of the toxic and synthetic function of the liver, and with the replication of viruses in the central nervous system. Due to the fact that cognitive dysfunction is associated with chronic persistence of viruses, their participation in the development of these extrahepatic manifestations was studied. Analysis of the role of viral agents in the formation of impairments in cognitive functions can improve the effectiveness of diagnostic and therapeutic methods in this category of patients.
Purpose: to systematize and evaluate the development of cognitive functions in patients with chronic viral hepatitis according to modern literature.
Search strategy: The search for sources was carried out in the databases PubMed, The Сochrane Library, Scopus, elibrary. The search depth was 15 years from 2005 to 2020. Inclusion criteria: reports of randomized and cohort studies, meta-analyzes and systematic reviews; articles in English and Russian. Exclusion criteria: materials with no evidence base, newspaper articles. During the search, 86 sources were found, of which 31 sources were selected and analyzed for a more detailed study.
Results: The analysis of the relationship between the formation of cognitive impairments and the development of the infectious process in viral hepatitis was carried out. The effect of various factors in the formation of cognitive dysfunction in patients with CVH was determined, the role of antiviral therapy in CVH on the dynamics of the development of cognitive dysfunctions was assessed.
Conclusions: Development of an infectious process in CVH affects the formation and progression of cognitive impairment. However, timely conducted in clinical trials antiviral therapy for CVH showed positive results in reducing and reversing cognitive dysfunctions.
Tatyana V. Polukchi, https://orcid.org/0000-0002-6134-884X
Yelena A. Slavko, https://orcid.org/0000-0001-6335-6125
Gulzhan N. Abuova, https://orcid.org/0000-0002-1210-2018
1 Kazakh Medical University of Continuing Education,
Almaty, Republic of Kazakhstan.
2 South Kazakhstan Medical Academy,
Shymkent, Republic of Kazakhstan.
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17. Chen D.S. et al. Strategies to manage hepatitis C virus infection disease burden-Volume 4. J. Viral Hepat. Blackwell Publishing Ltd, 2017. 24 Suppl 2:44-63.
18. Conde I., Vinaixa C., Berenguer M. Hepatitis C-related cirrhosis. Current status. Med Clin (Barc). 2017 Jan 20;148(2):78-85.
19. Fletcher N.F., McKeating J.A. Hepatitis C virus and the brain. J Viral Hepat. 2012;19:301-306.
20. Fletcher N.F., Wilson G.K., Murray J., Hu K., Lewis A., Reynolds G.M., Stamataki Z., Meredith L.W., Rowe I.A., Luo G. Hepatitis C virus infects the endothelial cells of the blood-brain barrier. Gastroenterology. 2012;142:634-643.e6.
21. Flores-Chávez A., Carrion J.A., Forns X., Ramos-Casals M. Extrahepatic manifestations associated with Chronic Hepatitis C Virus Infection. Rev Esp Sanid Penit. 2017 Dec;19(3):87-97.
22. Forton D.M., Allsop J.M., Main J., Foster G.R., Thomas H.C., Taylor-Robinson S.D. Evidence for a cerebral effect of the hepatitis C virus. Lancet. 2001;358:38-39.
23. Lanini S., Ustianowski A., Pisapia R., Zumla A., Ippolito G. Viral Hepatitis: Etiology, Epidemiology, Transmission, Diagnostics, Treatment, and Prevention. Infect Dis Clin North Am. 2019 Dec;33(4):1045-1062.
24. Monaco S., Mariotto S., Ferrari S., Calabrese M., Zanusso G., Gajofatto A., Sansonno D., Dammacco F. Hepatitis C virus-associated neurocognitive and neuropsychiatric disorders: Advances in 2015. World J Gastroenterol. 2015 Nov 14;21(42):11974-83.
25. Pawełczyk A. Consequences of extrahepatic manifestations of hepatitis C viral infection (HCV). Postepy Hig Med Dosw (Online). 2016 Apr21;70:349-59.
26. Perry W., Hilsabeck R.C., Hassanein T.I. Cognitive dysfunction in chronic hepatitis C: a review. DigDisSci. 2008 Feb;53(2):307-21.
27. Razavi H. et al. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm. J Viral Hepat. 2014 May;21 Suppl 1:34-59.
28. Senzolo M., Schiff S., D’Aloiso C.M., Crivellin C., Cholongitas E., Burra P., Montagnese S. Neuropsychological alterations in hepatitis C infection: the role of inflammation. World J Gastroenterol. 2011;17:3369-3374.
29. Wedemeyer H. et al. Strategies to manage hepatitis C virus (HCV) disease burden. J Viral Hepat. 2014 May;21 Suppl 1:60-89.
30. Wilkinson J., Radkowski M., Laskus T. Hepatitis C virus neuroinvasion: identification of infected cells. J Virol. 2009 Feb;83(3):1312-9.
31. Wozniak M.A., Lugo Iparraguirre L.M., Dirks M., Deb-Chatterji M., Pflugrad H., Goldbecker A., Tryc A.B., Worthmann H., Gess M., Crossey M.M., Forton D.M., Taylor-Robinson S.D., Itzhaki R.F., Weissenborn K. Apolipoprotein E-ε4 deficiency and cognitive function in hepatitis C virus-infected patients. J Viral Hepat. 2016 Jan;23(1):39-46.
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Polukchi T.V., Slavko Ye.A., Abuova G.N. Modern concepts of the role of chronic viral hepatitis in the development of cognitive impairment // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 4, pp. 58-65. doi 10.34689/SH.2021.23.4.006Related publications:
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