Depressive symptoms and viral clearance in patients receiving interferon-α and ribavirin for hepatitis C

Charles L. Raison, Sherry D. Broadwell, Andrey S. Borisov, Amita K. Manatunga, Lucile Capuron, Bobbi J. Woolwine, Ira M. Jacobson, Charles B. Nemeroff, Andrew H. Miller

Research output: Contribution to journalArticle

118 Scopus citations

Abstract

Interferon (IFN)-α plus ribavirin is an effective treatment for hepatitis C virus (HCV) infection, but is associated with a high rate of depression. Depression has been linked to a worse outcome in multiple medical disorders including viral illnesses. We examined whether increased symptoms of depression during IFN-α/ribavirin therapy were associated with a reduced treatment response as assessed by clearance of HCV. Depressive symptoms were evaluated in 102 HCV-infected patients at baseline and after 4, 8, 12, and 24 weeks of pegylated IFN-α-2b plus ribavirin therapy using the Zung self-rating depression scale (SDS). Viral clearance was determined at 24 weeks by polymerase chain reaction (PCR). Only 34% of subjects (10 out of 29) with a 20-point or greater increase in SDS Index score were HCV PCR negative at 24 weeks, compared to 59% (24 out of 41) of patients with a 10-19 point increase in SDS Index and 69% (22 out of 32) of patients with a less than 10 point increase (χ2=7.6, df=2, p<0.05). In addition, a 20-point or greater increase in SDS Index score during IFN-α/ribavirin therapy significantly predicted failure to clear virus when considered alone [crude odds ratio (OR), 3.2; 95% confidence interval (CI), 1.3-8.0; p<0.01] or when controlling for other factors that affected IFN-α treatment response (adjusted OR, 3.6; 95% CI, 1.3-9.5; p=0.01). These preliminary findings suggest that individuals who experience significant increases in depressive symptoms during IFN-α/ribavirin therapy may be less likely to clear virus, highlighting the importance of identifying and treating depressive symptoms in this patient population.

Original languageEnglish (US)
Pages (from-to)23-27
Number of pages5
JournalBrain, Behavior, and Immunity
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

Keywords

  • Cytokines
  • Depression
  • Gastroenterology
  • Hepatitis C
  • Interferon-α
  • Mood disorders
  • Ribavirin
  • Viral genotype
  • Viral load

ASJC Scopus subject areas

  • Immunology
  • Behavioral Neuroscience
  • Endocrine and Autonomic Systems

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    Raison, C. L., Broadwell, S. D., Borisov, A. S., Manatunga, A. K., Capuron, L., Woolwine, B. J., Jacobson, I. M., Nemeroff, C. B., & Miller, A. H. (2005). Depressive symptoms and viral clearance in patients receiving interferon-α and ribavirin for hepatitis C. Brain, Behavior, and Immunity, 19(1), 23-27. https://doi.org/10.1016/j.bbi.2004.05.001