A patient with chronic viral hepatitis C (HCV) may develop a cognitive impairment that may range from mild to severe. This may be due to a variety of factors some of which can modified while others cannot be.
Conditions associated with cognitive impairment:
(1) hepatic encephalopathy associated with end-stage liver disease
(2) chronic use of alcohol
(3) abuse of methamphetamines and other drugs
(4) concurrent HIV infection
(5) interferon and other medications
(6) chronic HCV infection itself, possibly due to cytokine production
(7) depression and other psychiatric comorbidities
(8) vitamin deficiencies (especially if abusing drugs and/or alcohol)
The cognitive impairment may be described as:
(1) difficulty thinking or concentrating
(2) "brain fog"
(3) difficulty recalling everyday information
(4) impaired attention
Detection and monitoring of the cognitive impairment can be done using neuropsychological testing.
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