Sustained Virological Response in the Antiviral Therapy of Chronic Hepatitis C: Is There a Predictive Value of Interferon-Induced Depression?

Abstract

Background: The study objective was to determine the contribution of cytokine-induced depression to a predictive model of sustained virological response (SVR) in chronic hepatitis C. Methods: One hundred and one therapy-naïve hepatitis C virus (HCV) outpatients received treatment with peginterferon alfa-2b and ribavirin. Neuropsychiatric side effects were monitored prospectively (Hospital Anxiety and Depression Scale, DSM-IV criteria for major depression). SVR was defined as a failure to detect HCV by PCR 24 weeks after therapy. Results: SVR rate was 72.3% (73 of 101 patients). Classification data and the extent of interferon-induced depression were not significantly linked to SVR. Virus genotype (p = 0.045) and gender (p = 0.016) contributed significantly to a logistic regression model. Mean (p = 0.811) and maximum (p = 0.744) depression increases were no significant predictors of SVR. Major depression rates (DSM-IV criteria) were 12.3% (9 of 73 patients) in the subgroup with SVR and 10.7% (3 of 28) in patients without SVR. Conclusions: We found no significant association between depression and the efficacy of antiviral treatment in chronic hepatitis C. Interferon-induced depressive symptoms are important to be monitored and treated if necessary; however, they cannot be used to predict therapy success.

Occurrence, course and risk factors of depression during antiviral treatment for chronic hepatitis C in patients with inherited bleeding disorders: a prospective study

“…They hypothesize that optimal dosing of IFN-a could be associated with both the development of depression and higher response rates [27]. Similar to the findings in the studies by Castéra et al and Schä fer et al, in our study no association at all was found between effect of antiviral therapy and depression [15,28].…”

“…Similar to the findings in the studies by Castéra et al. and Schäfer et al ., in our study no association at all was found between effect of antiviral therapy and depression [15,28].…”

The Importance of a Prior Psychiatric Examination in Pegylated Interferon and Ribavirin Combination Treatment for Chronic Hepatitis C

“…Kraus, et al [26] and Schaefer, et al similarly reported that preventative administration of SSRI before starting interferon treatment it was effective in patients with depression or a history of depression. Schafer, et al [27] reported no relation between the SVR rate and the development of depression. Loftis, et al [28] reported that major depressive disorder induced interferon-α might be a predictor of a positive response to interferon-α therapy.…”

“…However, psychiatric examinations may be impossible in some cases due to a lack of psychiatric clinics or cost performance issues. In such cases, the Hamilton Rating Scale for Depression, and the Montgomery-Asberg Depression Rating Scale (MADRS) [29] may be useful as clinician rated scales, or the Zung Self-rating Depression Scale [27], Beck's Depression Inventory (BDI) [30], and Hospital Anxiety and Depression Scale (HADS) [31] may be useful as self-rating scales to evaluate the risk of psychiatric disorders. In this study, the SVR rate was not significantly higher in the pre-treatment group (Group A) than in the non pretreatment group (Group B).…”

Mycophenolic Acid Inhibits Replication of Japanese Encephalitis Virus

“…Although, there are limitations of experimentation in mouse models with regard to the applicability of findings to human JEV infection, this is a widely accepted methodology to evaluate new antiviral compounds. Indeed, interferon-α, a known antiviral agent shown to be effective in vitro and in vivo in animal models against JEV, has been assessed in open human trials with encouraging results [19,20,21]. Since mycophenolic acid is already in clinical use for transplant patients [22], it may qualify as a candidate drug for evaluation in JEV infections.…”