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DEPRESSIVE SYMPTOMS AFTER INITIATION OF INTERFERON IN HUMAN IMMUNODEFICIENCY
VIRUS INFECTED PATIENTS WITH CRONIC HEPATITIS C
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Reported by Jules Levin
Laguno and colleagues from the ID Unit & the Psychiatry Department at
Hospital Clinic, in Barcelona, Spain presented results from this study at the 9th European AIDS Conference (EACS) in November 2003 on the frequency of depression they found in HCV/HIV coinfected patients who received interferon therapy for treatment of hepatitis C.
Interferon alpha (IFa) therapy for chronic hepatitis C (CHC) infection is
commonly associated with neuropsychiatric side effects, including depressive
symptoms. In the present study we evaluate the incidence and management of
depressive symptoms during IFa-therapy in HIV-infected patients with CHC.
HIV infected patients with CHC who began IFa and ribavirinin during the
recruitment period between April'01 and April'03 were included in the study.
Patients with past personal history of depressive disorder were excluded.
Of 109 co-infected patients who started the therapy during the recruitment
period, 40 (36.7%) referred depressive symptoms (sadness, tearfulness,
irritability,). Seventeen of them were treated with citalopram, a selective serotonin reuptake inhibitor antidepressant, and they showed a significant improvement of their symptoms. Four patients needed hospitalization and IFa removal due to severe depressive symptoms. Most of the patients (60%) referred depressive side effects in the first three months after initiation IFa.
The authors concluded that the incidence of depressive symptoms in patients
with HIV/HCV co-infection treated with interferon alpha is high. Most of the
depressive symptoms were mild to moderate and improved with antidepressant
therapy, without reduction or cessation of IFa therapy. During the first weeks
after initiating IFa therapy in HIV/HCV co-infection, close assessment of
psychiatric symptoms is recommended. Premature treating of these side effects with antidepressants would avoid early dropouts of interferon therapy.
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