“The virus has been linked to problems ranging from fatigue, depression, and anxiety to cognitive impairment,” says Rita Garcia-Martinez, MD, PhD, a researcher who has studied hepatitis C at the department of internal medicine at the Hospital General Universitario Gregorio Marañón in Madrid. She adds that many other people with hepatitis C may experience problems with concentration, attention, verbal learning, and working memory. The good news is, the same medication that can cure hepatitis C can also improve brain functioning among people with the infection.
Hepatitis C Is Linked to Brain Problems
Researchers suspect the brain fog and fatigue caused by hepatitis C is related to neuroinflammation (inflammation that occurs in the brain). Past studies have noted changes in brain regions that are also independent of liver failure, says Dr. Garcia-Martinez. Hepatitis C, it turns out, can “penetrate the central nervous system and replicate in the brain, causing inflammation,” she adds. That, in turn, slows down brain function. Feeling unwell has other ramifications. People who have been diagnosed with hepatitis C report feeling stigmatized and unsupported by their healthcare team and in personal relationships, reveals a review published in January 2019 in the journal Frontiers in Psychology. Cognitive impairment can also make people less likely to stick to a treatment that can cure their disease. A person’s quality of life and job satisfaction may also suffer, according to a review of past research published in the World Journal of Hepatology. While these changes are concerning, there is a bright spot, and that’s treatment. Taking direct-acting antiviral medication for 8 to 12 weeks can cure more than 90 percent of patients, notes the Centers for Disease Control and Prevention (CDC). With that comes brain benefits. A study by Garcia-Martinez, published in October 2021 in the European Journal of Neurology, found that clearing hepatitis C with antiviral medication can improve brain functioning. (In the study, about 21 percent of the 135 patients had cognitive impairment before starting treatment.) This was true for patients who had cirrhosis (late-stage liver scarring) as well as those without the complication. What’s more, these patients also reported that they were better able to function day-to-day. People with worse cognitive impairment before treatment also saw the biggest improvements, says Garcia-Martinez.
How to Cure Hep C ‘Brain Drain’
If you’ve been diagnosed with hepatitis C, it’s important to be treated right away, not only to decrease your risk of physical complications, such as cirrhosis, liver failure, and liver cancer, but also to protect your brain health. In general, the antivirals used to treat the infection are well tolerated and safe, according to a research review published in June 2019 in the journal Visceral Medicine. About one in 10 patients experience headache, fatigue, nausea, and diarrhea during treatment. A healthy lifestyle is important anytime, but especially during treatment. Be sure to eat a healthy diet and avoid drinking alcohol, advises the National Institute of Diabetes and Digestive and Kidney Diseases. (The liver breaks down alcohol, so teetotaling will support its recovery, according to Johns Hopkins Medicine.) Knowing you have hepatitis C is also key. The U.S. Department of Health and Human Services points out that half of people with hep C are unaware they’re infected. You could be living with symptoms, including cognitive ones, and have no idea that hep C is the underlying cause. All adults are advised to get screened at least once in their lives, and pregnant women should be screened during each pregnancy, advises the CDC. People who inject drugs (PWID) may need to be screened more frequently. Bottom line, there’s reason for optimism. “Hepatitis C infection is a reversible cause of cognitive impairment, no matter the liver disease stage,” says Garcia-Martinez.
