Depressive symptoms and viral clearance in patients receiving interferon-alpha and ribavirin for hepatitis C.
Brain, Behavior, and Immunity. 2005-01-01; 19(1): 23-27
DOI: 10.1016/j.bbi.2004.05.001
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1. Brain Behav Immun. 2005 Jan;19(1):23-7.
Depressive symptoms and viral clearance in patients receiving interferon-alpha
and ribavirin for hepatitis C.
Raison CL(1), Broadwell SD, Borisov AS, Manatunga AK, Capuron L, Woolwine BJ,
Jacobson IM, Nemeroff CB, Miller AH.
Author information:
(1)Department of Psychiatry and Behavioral Sciences, Emory University School of
Medicine, Atlanta, GA, USA.
Comment in
Brain Behav Immun. 2005 Jan;19(1):20-2.
Brain Behav Immun. 2005 Jul;19(4):271-2; author reply 273-4.
Interferon (IFN)-alpha 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-alpha/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-alpha-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 (chi2=7.6,
df=2, p