Impairments in fine-motor coordination and speed of information processing predict declines in everyday functioning in hepatitis C infection

Abstract

Research increasingly supports the neurovirulence of chronic infection with the hepatitis C virus (HCV). For example, HCV infection has been associated with neuropsychological impairment in several ability areas, including psychomotor skills. This study aimed to examine whether HCV-associated neuropsychological impairment is predictive of declines in the independent performance of physical (PADLs) and instrumental (IADLs) activities of daily living. A total of 106 volunteers with HCV infection completed a comprehensive neuropsychological, medical, and psychiatric research evaluation. As compared to 30 HCV-seronegative comparison participants, the HCV-infected group reported significantly greater declines in both PADLs and IADLs. Within the HCV cohort, individuals with impaired speed of information processing reported significantly greater IADL declines, whereas impaired fine-motor coordination was associated with declines in both IADLs and PADLs. In a series of regression analyses, impaired speed of information processing and depressive symptoms (as measured by the Beck Depression Inventory) were the only independent predictors of IADL declines, whereas general affective distress (as measured by the Profile of Mood States), sex, and fine-motor coordination impairment were predictive of declines in PADLs. Although the clinical assessment of HCV typically emphasizes both affective (e.g., depression) and physical factors, findings from the present study suggest that cognitive impairment is an important contributor to everyday functioning in persons living with HCV infection and therefore warrants consideration in clinical and research evaluations.

Keywords:

• Hepatitis
• Cognitive impairment
• Depression
• Activities of daily living
• Motor

This research was partially supported by National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA) Grants 5R01DA16015–03 (Scott L. Letendre, Principal Investigator), 5R01MH73419–03 (Steven P. Woods, Principal Investigator), and 5P01DA12065–07 (Igor Grant, Principal Investigator). The HIV Neurobehavioral Research Center (HNRC) is supported by Center award MH 62512 from the National Institute of Mental Health (NIMH).

The San Diego HNRC group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the Veterans Affairs San Diego Healthcare System, and it includes: Director: Igor Grant; Codirectors: J. Hampton Atkinson, Ronald J. Ellis, and J. Allen McCutchan; Center Manager: Thomas D. Marcotte; Naval Hospital San Diego: Braden R. Hale; Neuromedical Component: Ronald J. Ellis, J. Allen McCutchan, Scott Letendre, Edmund Capparelli, and Rachel Schrier; Neurobehavioral Component: Robert K. Heaton, Mariana Cherner, David J. Moore, and Steven Paul Woods; Neuroimaging Component: Terry Jernigan, Christine Fennema-Notestine, Sarah L. Archibald, John Hesselink, Jacopo Annese, Michael J. Taylor, and Brian Schweinsburg; Neurobiology Component: Eliezer Masliah, Ian Everall, and T. Dianne Langford; Neurovirology Component: Douglas Richman and David M. Smith; International Component: J. Allen McCutchan; Developmental Component: Ian Everall and Stuart Lipton; Clinical Trials Component: J. Allen McCutchan, Hampton Atkinson, Ronald J. Ellis, and Scott Letendre; Participant Accrual and Retention Unit: J. Hampton Atkinson and Rodney von Jaeger; Data Management Unit: Anthony C. Gamst, Clint Cushman (Data Systems Manager), and Daniel R. Masys (Senior Consultant); Statistics Unit: Ian Abramson, Christopher Ake, and Deborah Lazzaretto.

The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. The authors thank Chris Ake, Maria Buzzell, Jennifer Marquie-Beck, and Jacqueline Barajas for assistance with data coding and analysis.