Despite directly attacking the liver, the hepatitis C virus (HCV) can also damage other organs, such as the brain, in addition to affect the quality of life and mental health of those who become infected with.
This virus is transmitted primarily through blood, for example, by not sterilizing tattoo needles or equipment (or using disposable products), by unsterilized surgical instruments (such as at the dentist’s office), or by sharing equipment for intravenous drug injection. It can also remain on items that come into contact with blood and are not sterilized, such as manicure and pedicure tools.
Since it shares the blood-borne route of transmission with HIV, it is relatively common for people to have both viruses. However, unlike HIV, HCV infection can be cured.
Taking care of the brain
According to the HIV Treatment Working Group (gTt-HIV), more than half of people with HCV may have varying degrees of neurocognitive impairment, which has symptoms such as decreased speed of mental processing, impaired timing, of reaction, reduced attention span and fluency when speaking, as well as memory impairment.
In its most severe form, neurocognitive impairment can cause something called hepatic encephalopathy, which is a decline in brain function because, in the later stages of the disease, the liver can no longer remove toxins from the blood.
In addition to these problems in the brain, hepatitis C is a major health problem as it is one of the main causes of liver cancer. If we add to this that the infection does not usually cause symptoms until it is already very advanced, detection is essential to be able to treat the infection.
Mental health effects
A study recently published in the Journal of Viral Hepatitis looked at the improvement in mental health, specifically depression and anxiety, when people are cured of HCV.
The research team observed a cohort from Punjab, India, made up of 385 people who were cured with direct-acting antiviral (DAA) treatment, the most modern, most effective and shortest-acting treatment available against hepatitis c.
Using specialized medical questionnaires, depression, anxiety and health-related quality of life were analyzed. In addition, cognitive tests of visual and verbal memory, attention, arithmetic and reaction times were performed. All tests were performed at the beginning and end of DAA treatment, which consists of 12 weeks. The results were compared with healthy patients and with people with a condition called non-alcoholic fatty liver.
At the start of the study, people with HCV had significant cognitive impairment compared with healthy patients or those with NAFLD. They also had lower scores on cognitive tests compared to people with NAFLD; this indicates that cognitive impairment is related more to hepatitis C than to liver disease in general.
When tested at 12 weeks, people who had been cured of HCV had significant improvements in reaction time, visual memory, concentration, attention and processing skills, as well as short-term memory. And on the contrary, those who were not cured had worse scores compared to those obtained at the beginning of the study.
On the other hand, those who were cured of hepatitis C had significant improvements in depression and anxiety, while those who were not cured had no change in their baseline scores.
Importance of treatment
The study not only shows that hepatitis C is related to cognitive decline, but that treatment (in this case, with DAAs) helps significantly to improve cognitive ability and to reduce depression and anxiety.
The authors of the research conclude that hepatitis C must obtain universal attention, that is, treat all diagnosed people, to improve the health of the population and prevent the further spread of the virus.
Remember that HCV often co-occurs with HIV. If you don’t know if you have this other virus, at AHF Latin America and the Caribbean we carry out free tests. Locate our nearest office in your country or write to us on Whatsapp and take the test today.
