Role of Sleep Disturbance in Chronic Hepatitis C Infection

Chronic infection with the hepatitis C virus (CHC) is associated with physical and mental symptoms including fatigue and depression that adversely affect quality of life. A related complaint, sleep disturbance, has received little attention in the literature, with the exception of sleep changes noted in cirrhosis and end-stage liver disease. We present an overview of studies indicating sleep problems in patients with CHC, with about 60% to 65% of individuals reporting such complaints. Evidence suggests that impairments in sleep quality exist independent of antiviral therapy with interferon-α and prior to advanced stages of liver disease. Further investigation of sleep disturbance in CHC patients with a mild stage of liver disease may provide important information on disease course as well as allow additional opportunities for patient support

Neuropsychological functioning among individuals infected with hepatitis C: a comparison of pre- and post-transplant performance

t is well established that patients with end stage liver disease (ESLD) experience cognitive and mood problems; however, little is known about changes in cognitive and emotional functioning following liver transplantation, especially over the past decade with the epidemic of hepatitis C virus (HCV) infection taking over as the leading indication for liver transplantation. Seventeen patients with ESLD secondary to chronic HCV were assessed pre- and post-liver transplantation using a comprehensive neuropsychological battery. After an average of four years post-transplant, patients demonstrated significant improvements in most cognitive functioning and depressive symptoms. However, 18% of liver recipients continued to exhibit mild cognitive impairment mainly in areas of attention/executive functioning, motor speed, and learning. Liver transplantation is a life-extending surgery that reverses most, but not all, cognitive and mood difficulties. It is crucial to evaluate cognition after liver transplantation, especially in these three domains, and to consider the effect on daily functioning

Correspondence of the Boston Naming Test and Multilingual Naming Test in identifying naming impairments in a geriatric cognitive disorders clinic

Confrontation naming measures are commonly used for both diagnostic and clinical research purposes in populations of known or suspected neurodegenerative disorders. The Boston Naming Test (BNT) is the most widely used measure of confrontation naming but has been criticized for outdated and culturally biased content. A new naming measure, the Multilingual Naming Test (MiNT), has been developed that may address these limitations, but research regarding its validity and diagnostic performance relative to existing instruments is limited. The current study examined how the BNT and MiNT performed in a sample of older adults evaluated in an interprofessional memory disorders clinic. Eighty-six individuals (50.0% women) met the inclusion criteria and were included in the study. The average age of participants was 74.2 years ( = 7.7), and the average education was 16.7 years ( = 2.5). Most participants were non-Hispanic White (94.2%), and the remaining participants were Hispanic or Black. All participants completed a comprehensive evaluation in English and were administered both the BNT and the MiNT. The strength of agreement as indexed by CCC (.67) was modest for the sample as a whole. Eighty-seven-point five percent classification agreement for impaired normal naming performance was obtained. Eleven cases showed disagreement between BNT and MiNT classification of impairment, with seven of these being borderline score cases. Overall, the results suggest that the MiNT performs similarly at the identification of naming impairments as the BNT, though performance may diverge across different diagnostic groups and may be influenced by age