Viral suppression of hepatitis C virus–infected patients improved neural health as measured by magnetic resonance spectroscopy, according to findings from a new study.
Treatment led to an increase in the n-acetyl aspartate/creatine ratio in patients’ basal ganglia, according to Dr. Nezam H. Afdhal of Beth Israel Deaconess Medical Center, Boston.
Sherry Boschert/Frontline Medical NewsDr. Nezam H. Afdhal
Dr. Afdhal and his associates studied 14 treatment-naive HCV patients participating in the ION-1 trial. For 12 weeks, seven patients received combination ledipasvir/sofosbuvir; the other seven received the same combination plus ribavirin (RBV). All patients achieved sustained viral response (SVR) to treatment. Researchers used MR spectroscopy to evaluate signals from choline, creatine (Cr), n-acetyl aspartate (NAA), and myoinisitol. “MR spectroscopy showed an increase in the basal ganglia NAA/Cr ratio at week 4 that became significant at SVR (P = .0134) and more apparent in the RBV-free group,” Dr. Afdhal said at the annual meeting of the American Association for the Study of Liver Diseases.
“At week 12 post treatment, the NAA/Cr ratio in left basal ganglia increased in the RBV-free arm (P = .0156) and remained unchanged in the RBV-containing arm (P > .05),” he reported. After 12 weeks post treatment, some changes in the metabolite in the left basal ganglia shown by MR spectroscopy correlated with changes in the emotional function domain of a quality-of-life questionnaire and in the mental health scale of SF-36.
“Changes in the metabolite pattern captured by MR [spectroscopy] also may be associated with changes in patient reported outcomes related to mental health,” the authors said. “The role of HCV on neurocognition is undergoing further study in a double-blind placebo-controlled trial.”
The ION-1 trial was sponsored by Gilead Sciences, manufacturer of ledipasvir/sofosbuvir. Dr. Afdhal reported financial relationships with Gilead, Merck, Vertex, Idenix, GlaxoSmithKline, Springbank, Pharmasett, and Abbott.