Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 20
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Dantas-Duarte, Adriana Morais-de-Jesus, Mychelle Nunes, Ana Paula Miranda-Pettersen, Karine Araújo-de-Freitas, Lucas Netto, Liana R. Santos, Carlos Teles Codes, Liana and Quarantini, Lucas C. 2016. Risk-taking behavior and impulsivity among HCV-infected patients. Psychiatry Research, Vol. 243, p. 75.

    Dantas-Duarte, Adriana Morais-de-Jesus, Mychelle Nunes, Ana Paula Miranda-Pettersen, Karine Araújo-de-Freitas, Lucas Netto, Liana R. Santos, Carlos Teles Codes, Liana and Quarantini, Lucas C. 2016. Risk-Taking Behavior and Impulsivity among HCV-infected Patients. Psychiatry Research,

    Gill, Kirat Ghazinian, Hasmik Manch, Richard and Gish, Robert 2016. Hepatitis C virus as a systemic disease: reaching beyond the liver. Hepatology International, Vol. 10, Issue. 3, p. 415.

    Ibrahim, Ibtihal Salah, Hala El Sayed, Hanan Mansour, Hader Eissa, Ahmed Wood, Joel Fathi, Warda Tobar, Salwa Gur, Ruben C. Gur, Raquel E. Dickerson, Faith Yolken, Robert H El Bahaey, Wafaa and Nimgaonkar, Vishwajit 2016. Hepatitis C virus antibody titers associated with cognitive dysfunction in an asymptomatic community-based sample. Journal of Clinical and Experimental Neuropsychology, Vol. 38, Issue. 8, p. 861.

    Konat, Gregory 2016. Cerebral Response to Peripheral Challenge with a Viral Mimetic. Neurochemical Research, Vol. 41, Issue. 1-2, p. 144.

    Loftis, Jennifer M. Taylor, Jonathan Raué, Hans-Peter Slifka, Mark K. and Huang, Elaine 2016. Alcohol intake alters immune responses and promotes CNS viral persistence in mice. Behavioural Brain Research, Vol. 312, p. 1.

    Bassiony, MM Yousef, A Raya, Y El-Shabrawi, A Fouad, E and El-Shafeey, M 2015. The Relationship between Cognitive impairment and depression, anxiety and virological response in hepatitis C patients in Egypt. International Journal of Psychiatry in Clinical Practice, p. 1.

    Michalovicz, Lindsay T. and Konat, Gregory W. 2014. Peripherally restricted acute phase response to a viral mimic alters hippocampal gene expression. Metabolic Brain Disease, Vol. 29, Issue. 1, p. 75.

    Correia, Stephen Cohen, Ronald Gongvatana, Assawin Ross, Skye Olchowski, James Devlin, Kathryn Tashima, Karen Navia, Bradford and Delamonte, Suzanne 2013. Relationship of plasma cytokines and clinical biomarkers to memory performance in HIV. Journal of Neuroimmunology, Vol. 265, Issue. 1-2, p. 117.

    Forton, Daniel M. Taylor-Robinson, Simon Gess, Markus and Thomas, Howard C. 2013. Viral Hepatitis.

    Sakamoto, Maiko Woods, Steven Paul Kolessar, Michael Kriz, Daniel Anderson, J. Renee Olavarria, Hannah Sasaki, Anna W. Chang, Michael Flora, Kenneth D. Loftis, Jennifer M. and Huckans, Marilyn 2013. Protective effects of higher cognitive reserve for neuropsychological and daily functioning among individuals infected with hepatitis C. Journal of NeuroVirology, Vol. 19, Issue. 5, p. 442.

    Morgan, Erin E. Woods, Steven Paul Rooney, Alexandra Perry, William Grant, Igor Letendre, Scott L. and the HIV Neurobehavioral Research Pr, 2012. Intra-Individual Variability Across Neurocognitive Domains in Chronic Hepatitis C Infection: Elevated Dispersion is Associated With Serostatus and Unemployment Risk. The Clinical Neuropsychologist, Vol. 26, Issue. 4, p. 654.

    Sassoon, Stephanie A. Rosenbloom, Margaret J. Fama, Rosemary Sullivan, Edith V. and Pfefferbaum, Adolf 2012. Selective neurocognitive deficits and poor life functioning are associated with significant depressive symptoms in alcoholism–HIV infection comorbidity. Psychiatry Research, Vol. 199, Issue. 2, p. 102.

    Huckans, Marilyn Seelye, Adriana Woodhouse, Jonathan Parcel, Tiffany Mull, Lisa Schwartz, Daniel Mitchell, Alex Lahna, David Johnson, Amy Loftis, Jennifer Woods, Steven Paul Mitchell, Suzanne H. and Hoffman, William 2011. Discounting of delayed rewards and executive dysfunction in individuals infected with hepatitis C. Journal of Clinical and Experimental Neuropsychology, Vol. 33, Issue. 2, p. 176.

    Loftis, Jennifer M. Huckans, Marilyn and Morasco, Benjamin J. 2010. Neuroimmune mechanisms of cytokine-induced depression: Current theories and novel treatment strategies. Neurobiology of Disease, Vol. 37, Issue. 3, p. 519.

    Morasco, Benjamin J. Huckans, Marilyn Loftis, Jennifer M. Woodhouse, Jonathan Seelye, Adriana Turk, Dennis C. and Hauser, Peter 2010. Predictors of pain intensity and pain functioning in patients with the hepatitis C virus. General Hospital Psychiatry, Vol. 32, Issue. 4, p. 413.

    Fuller, Bret E Loftis, Jennifer M Rodriguez, Veronica L McQuesten, Matthew J and Hauser, Peter 2009. Psychiatric and substance use disorders comorbidities in veterans with hepatitis C virus and HIV coinfection. Current Opinion in Psychiatry, Vol. 22, Issue. 4, p. 401.

    Martin-Thormeyer, Eileen M. and Paul, Robert H. 2009. Drug Abuse and Hepatitis C Infection as Comorbid Features of HIV Associated Neurocognitive Disorder: Neurocognitive and Neuroimaging Features. Neuropsychology Review, Vol. 19, Issue. 2, p. 215.

    Posada, Carolina Morgan, Erin E. Moore, David J. Woods, Steven Paul Letendre, Scott L. and Grant, Igor 2009. Neurocognitive Effects of the Hepatitis C Virus. Current Hepatitis Reports, Vol. 8, Issue. S1, p. 18.

    Quelhas, Rosa and Lopes, Alice 2009. Psychiatric Problems in Patients Infected with Hepatitis C Before and During Antiviral Treatment with Interferon-Alpha: A Review. Journal of Psychiatric Practice, Vol. 15, Issue. 4, p. 262.

  • Journal of the International Neuropsychological Society, Volume 15, Issue 1
  • January 2009, pp. 69-82

The cognitive effects of hepatitis C in the presence and absence of a history of substance use disorder

  • MARILYN HUCKANS (a1) (a2) (a3), ADRIANA SEELYE (a1) (a4), TIFFANY PARCEL (a1) (a4), LISA MULL (a1) (a4), JONATHAN WOODHOUSE (a1) (a5), DANELL BJORNSON (a1) (a6), BRET E. FULLER (a1) (a2), JENNIFER M. LOFTIS (a1) (a2) (a3) (a7), BENJAMIN J. MORASCO (a1) (a2), ANNA W. SASAKI (a1) (a8), DANIEL STORZBACH (a2) and PETER HAUSER (a1) (a2) (a3) (a7) (a8) (a9)
  • DOI:
  • Published online: 01 January 2009

The aim of the study was to determine whether infection with the hepatitis C virus (HCV) is associated with cognitive impairment beyond the effects of prevalent comorbidities and a history of substance use disorder (SUD). Adult veterans were recruited from the Portland Veterans Affairs Medical Center into three groups: (1) HCV+/SUD+ (n = 39), (2) HCV+/SUD− (n = 24), and (3) HCV−/SUD− (n = 56). SUD+ participants were in remission for ≥90 days, while SUD− participants had no history of SUD. Groups did not significantly differ in terms of rates of psychiatric or medical comorbidities. Procedures included clinical interviews, medical record reviews, and neuropsychological testing. Significant group differences were found in the domains of Verbal Memory, Auditory Attention, Speeded Visual Information Processing, and Reasoning/Mental Flexibility (p ≤ .05). Post hoc comparisons indicated that HCV+/SUD− patients performed significantly worse than HCV−/SUD− controls on tests measuring verbal learning, auditory attention, and reasoning/mental flexibility, but only HCV+/SUD+ patients did worse than HCV−/SUD− controls on tests of speeded visual information processing. Results indicate that chronic HCV is associated with cognitive impairment in the absence of a history of SUD. The most robust deficits appear to be in verbal learning and reasoning/mental flexibility. (JINS, 2009, 15, 69–82.)

Corresponding author
*Correspondence and reprint requests to: Marilyn Huckans, Portland VA Medical Center (P3MHDC), 3710 SW US Veteran’s Hospital Road, Portland, OR 97239. E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

D.M. Adair , M. Radkowski , J. Jablonska , A. Pawelczyk , J. Wilkinson , J. Rakela , & T Laskus . (2005). Differential display analysis of gene expression in brains from hepatitis C-infected patients. AIDS, 19(Suppl 3), S145S150.

M.L. Bleecker , D.P. Ford , M.A. Celio , C.G. Vaughan ,& K.N Lindgren . (2007). Impact of cognitive reserve on the relationship of lead exposure and neurobehavioral performance. Neurology, 69(5), 470476.

C.L. Carey , S.P. Woods , R. Gonzalez , E. Conover , T.D. Marcotte , I. Grant , & R.K Heaton . (2004). Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection. Journal of Clinical and Experimental Neuropsychology, 26(3), 307319.

M. Cherner , S. Letendre , R.K. Heaton , J. Durelle , J. Marquie-Beck , B. Gragg , & I Grant . (2005). Hepatitis C augments cognitive deficits associated with HIV infection and methamphetamine. Neurology, 64(8), 13431347.

A Collie . (2005). Cognition in liver disease. Liver International, 25(1), 18.

J. Cordoba , M. Flavia , C. Jacas , S. Sauleda , J.I. Esteban , V. Vargas , R. Esteban , & J Guardia . (2003). Quality of life and cognitive function in hepatitis C at different stages of liver disease. Journal of Hepatol, 39(2), 231238.

D.M. Forton , J.M. Allsop , J. Main , G.R. Foster , H.C. Thomas , & S.D Taylor-Robinson . (2001). Evidence for a cerebral effect of the hepatitis C virus. Lancet, 358(9275), 3839.

D.M. Forton , P. Karayiannis , N. Mahmud , S.D. Taylor-Robinson , & H.C Thomas . (2004). Identification of unique hepatitis C virus quasispecies in the central nervous system and comparative analysis of internal translational efficiency of brain, liver, and serum variants. Journal of Virology, 78(10), 51705183.

D.M. Forton , S.D. Taylor-Robinson , & H.C Thomas . (2003). Cerebral dysfunction in chronic hepatitis C infection. Journal of Viral Hepatitis, 10(2), 8186.

D.M. Forton , S.D. Taylor-Robinson , & H.C Thomas . (2006). Central nervous system changes in hepatitis C virus infection. European Journal of Gastroenterology and Hepatology, 18(4), 333338.

D.M. Forton , H.C. Thomas , C.A. Murphy , J.M. Allsop , G.R. Foster , J. Main , K.A. Wesnes , & S.D Taylor-Robinson . (2002). Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology, 35(2), 433439.

Global burden of disease (GBD) for hepatitis C. (2004). Journal of Clinical Pharmacology, 44(1), 2029.

M. Gossop , J. Marsden , & D Stewart . (2002). Dual dependence: Assessment of dependence upon alcohol and illicit drugs, and the relationship of alcohol dependence among drug misusers to patterns of drinking, illicit drug use and health problems. Addiction, 97(2), 169178.

R.C. Hilsabeck , T.I. Hassanein , M.D. Carlson , E.A. Ziegler , & W Perry . (2003). Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C. Journal of the International Neuropsychological Society, 9(6), 847854.

R.C. Hilsabeck , W. Perry , & T.I Hassanein . (2002). Neuropsychological impairment in patients with chronic hepatitis C. Hepatology, 35(2), 440446.

M.S. Huckans , A.D. Blackwell , T.A. Harms , & P Hauser . (2006). Hepatitis C disease management patterns in high-risk populations: Testing, infection, and treatment rates among patients with schizophrenia, schizoaffective disorder, and substance use disorders. Psychiatric Services, 57(3), 403406.

M.S. Huckans , A.D. Blackwell , T.A. Harms , D.W. Indest , & P Hauser . (2005). Integrated hepatitis C virus treatment: addressing comorbid substance use disorders and HIV infection. AIDS, 19(Suppl 3), S106S115.

K. Karaivazoglou , K. Assimakopoulos , K. Thomopoulos , G. Theocharis , L. Messinis , G. Sakellaropoulos , & C Labropoulou-Karatza . (2007). Neuropsychological function in Greek patients with chronic hepatitis C. Liver International, 27(6), 798805.

H Klove . (1963). Clinical neuropsychology. Medical Clinics of North America, 47, 16471658.

M.R. Kraus , A. Schafer , S. Wissmann , P. Reimer , & M Scheurlen . (2005). Neurocognitive changes in patients with hepatitis C receiving interferon alfa-2b and ribavirin. Clinical Pharmacology and Therapeutics, 77(1), 90100.

C. Lackner , G. Struber , B. Liegl , S. Leibl , P. Ofner , C. Bankuti , B. Bauer , & R.E Stauber . (2005). Comparison and validation of simple noninvasive tests for prediction of fibrosis in chronic hepatitis C. Hepatology, 41(6), 13761382.

T. Laskus , M. Radkowski , D.M. Adair , J. Wilkinson , A.C. Scheck , & J Rakela . (2005). Emerging evidence of hepatitis C virus neuroinvasion. AIDS, 19(Suppl 3), S140S144.

T. Laskus , M. Radkowski , A. Bednarska , J. Wilkinson , D. Adair , M. Nowicki , G.B. Nikolopoulou , H. Vargas , & J Rakela . (2002). Detection and analysis of hepatitis C virus sequences in cerebrospinal fluid. Journal of Virology, 76(19), 1006410068.

S.L. Letendre , M. Cherner , R.J. Ellis , J. Marquie-Beck , B. Gragg , T. Marcotte , R.K. Heaton , J.A. McCutchan , & I Grant . (2005). The effects of hepatitis C, HIV, and methamphetamine dependence on neuropsychological performance: Biological correlates of disease. AIDS, 19(Suppl 3), S72S78.

K. Lieb , M.A. Engelbrecht , O. Gut , B.L. Fiebich , J. Bauer , G. Janssen , & M Schaefer . (2006). Cognitive impairment in patients with chronic hepatitis treated with interferon alpha (IFNalpha): Results from a prospective study. European Psychiatry, 21(3), 204210.

J.M. Loftis , A.M. Matthews , & P Hauser . (2006). Psychiatric and substance use disorders in individuals with hepatitis C: Epidemiology and management. Drugs, 66(2), 155174.

F. Maggi , M. Giorgi , C. Fornai , A. Morrica , M.L. Vatteroni , M. Pistello , G. Siciliano , A. Nuccorini , & M Bendinelli . (1999). Detection and quasispecies analysis of hepatitis C virus in the cerebrospinal fluid of infected patients. Journal of Neurovirology, 5(3), 319323.

S.F Maier . (2003). Bi-directional immune-brain communication: Implications for understanding stress, pain, and cognition. Brain, Behavior, and Immunity, 17(2), 6985.

M.F. Martelli , N.D. Zasler , M.C. Bender , & K Nicholson . (2004). Psychological, neuropsychological, and medical considerations in assessment and management of pain. Journal of Head Trauma Rehabilitation, 19(1), 1028.

E.M. Martin , R.M. Novak , M. Fendrich , J. Vassileva , R. Gonzalez , S. Grbesic , G. Nunnally , & L Sworowski . (2004). Stroop performance in drug users classified by HIV and hepatitis C virus serostatus. Journal of the International Neuropsychological Society, 10(2), 298300.

M.P. McAndrews , K. Farcnik , P. Carlen , A. Damyanovich , M. Mrkonjic , S. Jones , & E.J Heathcote . (2005). Prevalence and significance of neurocognitive dysfunction in hepatitis C in the absence of correlated risk factors. Hepatology, 41(4), 801808.

V. Michiels & R Cluydts . (2001). Neuropsychological functioning in chronic fatigue syndrome: A review. Acta Psychiatrica Scandinavica, 103(2), 8493.

G.M. Miele , K.M. Carpenter , M.S. Cockerham , K.D. Trautman , J. Blaine , & D.S Hasin . (2001). Substance Dependence Severity Scale: Reliability and validity for ICD-10 substance use disorders. Addictive Behaviors, 26(4), 603612.

G. Morsica , M.T. Bernardi , R. Novati , C. Uberti Foppa , A. Castagna , & A Lazzarin . (1997). Detection of hepatitis C virus genomic sequences in the cerebrospinal fluid of HIV-infected patients. Journal of Medical Virology, 53(3), 252254.

H.F. Moselhy , G. Georgiou , & A Kahn . (2001). Frontal lobe changes in alcoholism: A review of the literature. Alcohol and Alcoholism, 36(5), 357368.

M. Pereda , J.L. Ayuso-Mateos , A. Gomez Del Barrio , S. Echevarria , M.C. Farinas , D. Garcia Palomo , J. Gonzalez Macias , & J.L Vazquez-Barquero . (2000). Factors associated with neuropsychological performance in HIV-seropositive subjects without AIDS. Psychological Medicine, 30(1), 205217.

A. Pfennig , E. Littmann , & M Bauer . (2007). Neurocognitive impairment and dementia in mood disorders. Journal of Neuropsychiatry and Clinical Neurosciences, 19(4), 373382.

R.J. Porter , C. Bourke , & P Gallagher . (2007). Neuropsychological impairment in major depression: Its nature, origin and clinical significance. The Australian and New Zealand Journal of Psychiatry, 41(2), 115128.

M. Radkowski , J. Wilkinson , M. Nowicki , D. Adair , H. Vargas , C. Ingui , J. Rakela , & T Laskus . (2002). Search for hepatitis C virus negative-strand RNA sequences and analysis of viral sequences in the central nervous system: Evidence of replication. Journal of Virology, 76(2), 600608.

R.B Reitan . (1955). Investigation of the validity of Halstead’s measures of biological intelligence. Archives of Neurology and Psychiatry, 73, 2835.

S.A. Ropacki , A.A. Bert , M.T. Ropacki , B.L. Rogers , & R.A Stern . (2007). The influence of cognitive reserve on neuropsychological functioning following coronary artery bypass grafting (CABG). Archives of Clinical Neuropsychology, 22(1), 7385.

W.G Rosen . (1980). Verbal fluency in aging and dementia. Journal of Clinical Neuropsychology, 2, 135146.

L.B. Seeff & J.H Hoofnagle . (2003). Appendix: The National Institutes of Health Consensus Development Conference management of hepatitis C 2002. Clinics in Liver Disease, 7(1), 261287.

A.K. Silberbogen , E.A. Janke , & C Hebenstreit . (2007). A closer look at pain and hepatitis C: Preliminary data from a veteran population. Journal of Rehabilitation Research and Development, 44(2), 231244.

R.A. Stern , S.G. Silva , N. Chaisson , & D.L Evans . (1996). Influence of cognitive reserve on neuropsychological functioning in asymptomatic human immunodeficiency virus-1 infection. Archives of Neurology, 53(2), 148153.

Y Stern . (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders, 20(3 Suppl 2), S69S74.

A. Verdejo-Garcia , F. Lopez-Torrecillas , C.O. Gimenez , & M Perez-Garcia . (2004). Clinical implications and methodological challenges in the study of the neuropsychological correlates of cannabis, stimulant, and opioid abuse. Neuropsychology Review, 14(1), 141.

P.W. Vik , T. Cellucci , A. Jarchow , & J Hedt . (2004). Cognitive impairment in substance abuse. The Psychiatric Clinics of North America, 27(1), 97109, ix.

H.J. von Giesen , T. Heintges , N. Abbasi-Boroudjeni , S. Kucukkoylu , H. Koller , B.A. Haslinger , M. Oette , & G Arendt . (2004). Psychomotor slowing in hepatitis C and HIV infection. Journal of Acquired Immune Deficiency Syndromes, 35(2), 131137.

C.T. Wai , J.K. Greenson , R.J. Fontana , J.D. Kalbfleisch , J.A. Marrero , H.S. Conjeevaram , & A.S Lok . (2003). A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology, 38(2), 518526.

K. Weissenborn , J. Krause , M. Bokemeyer , H. Hecker , A. Schuler , J.C. Ennen , B. Ahl , M.P. Manns , & K.W Boker . (2004). Hepatitis C virus infection affects the brain-evidence from psychometric studies and magnetic resonance spectroscopy. Journal of Hepatology, 41(5), 845851.

A.J. Whitehead , S.K. Dobscha , B.J. Morasco , S. Ruimy , C. Bussell , & P Hauser . (2008). Pain, substance use disorders and opioid analgesic prescription patterns in veterans with hepatitis C. Journal of Pain Symptom Management, 36(1), 3945.

C.J. Wilson , C.E. Finch , & H.J Cohen . (2002). Cytokines and cognition—The case for a head-to-toe inflammatory paradigm. Journal of the American Geriatrics Society, 50(12), 20412056.

M.J. Taylor , S.L. Letendre , B.C. Schweinsburg , O.M. Alhassoon , G.G. Brown , A. Gongvatana , I. Grant , & The HNRC. (2004). Hepatitis C virus infection is associated with reduced white matter N-acetylaspartate in abstinent methamphetamine users. Journal of the International Neuropsychological Society, 10, 110113.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *