Chronic hepatitis C virus infection and neurocognitive function in adult survivors of childhood cancer. Issue 22 (25th July 2017)

• Record Type: Journal Article
• Authors: Studaway, Adrienne; Ojha, Rohit P.; Brinkman, Tara M.; Zhang, Nan; Baassiri, Malek; Banerjee, Pia; Ehrhardt, Matthew J.; Srivastava, Deokumar; Robison, Leslie L.; Hudson, Melissa M.; Krull, Kevin R.
• Is Part Of: Cancer. Volume 123:Issue 22(2017)
• Page Start: 4498
• Page End: 4505
• Publication Date: 2017-07-25
• Subjects: adult -- childhood cancer -- cognitive function -- hepatitis C -- long‐term survivors -- quality of life; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.30913
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : BACKGROUND: Cancer survivors transfused with blood products before reliable screening for hepatitis C virus (HCV) are at risk for infection. This study examined the impact of HCV on neurocognitive function and health‐related quality of life (HRQOL) among adult survivors of childhood cancer. METHODS: Neurocognitive testing was conducted for 836 adult survivors of childhood cancer (mean age, 35 years [standard deviation, 7.4 years]; time since diagnosis, 29 years [standard deviation, 6.2 years]) who received blood products before universal HCV screening. No differences were observed between confirmed HCV‐seropositive survivors (n = 79) and HCV‐seronegative survivors (n = 757) in the primary diagnosis or neurotoxic therapies. Multivariate regression models were used to compare functional outcomes between seropositive and seronegative survivors. RESULTS: Compared with seronegative survivors, seropositive survivors demonstrated lower performance on measures of attention ( P < .001), processing speed ( P = .008), long‐term verbal memory ( P = .01), and executive function ( P = .001). After adjustments for sex, age at diagnosis, and treatment exposures, seropositive survivors had a higher prevalence of impairment in processing speed (prevalence ratio [PR], 1.3; 95% confidence interval [CI], 1.1‐1.6) and executive functioning (PR, 1.3; 95% CI, 1.1‐1.6). Differences were not associated with the treatment of HCV or the presence of liver cirrhosis. Seropositive survivors reported worse general HRQOL (PR, 1.6; 95% CI, 1.2‐2.1), which was associated with the presence of liver cirrhosis ( P = .001). CONCLUSIONS: Survivors of childhood cancer with a history of HCV infection are at risk for neurocognitive impairment and reduced HRQOL beyond the known risks associated with neurotoxic cancer therapies. Cancer 2017;123:4498‐505 . © 2017 American Cancer Society . Abstract : Hepatitis C virus–seropositive survivors demonstrate poorer neurocognitive function and health‐related quality‐of‐life than hepatitis C virus–seronegative survivors. The diagnosis of liver cirrhosis does not account for the poorer neurocognitive function observed in this cohort.