Depressive symptoms after initiation of interferon therapy in human immunodeficiency virus-infected patients with chronic hepatitis C.
BACKGROUND
Interferon alpha (IFN-alpha) therapy for chronic hepatitis C (CHC) infection is commonly associated with neuropsychiatric side effects including depressive symptomatology. In this study, we evaluated the incidence and management of depressive symptoms during IFN-alpha therapy in HIV-infected patients with CHC.


METHODS
HIV-infected patients with CHC who began IFN-alpha and ribavirin therapy during the recruitment period April 2001 to April 2003 were included in the study. Patients with a history of major depressive disorder were excluded.


RESULTS
Of 113 co-infected patients who started IFN-alpha therapy during the recruitment period, 45 (40%) developed symptoms of depression (sadness, tiredness and apathy). Twenty of them (44%) were treated with citalopram, a selective serotonin re-uptake inhibitor, resulting in a significant improvement in their symptoms. Most of the patients (60%) showed depressive side effects in the first 3 months after initiation of IFN-alpha. In addition, during the study, three patients developed psychotic symptoms and one committed suicide.


CONCLUSIONS
The incidence of depressive symptoms in patients with HIV/HCV co-infection treated with IFN-alpha is high. Most of the depressive symptoms were not severe and improved with antidepressant therapy, without reduction or cessation of IFN-alpha therapy. During the first weeks after initiating IFN-alpha therapy for HIV/HCV co-infection, close assessment of psychiatric symptoms is recommended. Early treatment of these side effects with antidepressants would help avoid early dropouts from interferon therapy.
Laguno
Montserrat
M
Infectious Diseases Unit, Hospital Clinic Universitari de Barcelona, Barcelona, Spain. garcia@clinic.ub.es
Blanch
Jordi
J
Murillas
Javier
J
Blanco
Jose Luis
JL
León
Agothe
A
Lonca
Montserrat
M
Larrousse
Mario
M
Biglia
Alejandra
A
Martinez
Esteban
E
García
Felipe
F
Miró
Jose M
JM
de Pablo
Joan
J
Gatell
Josep M
JM
Mallolas
Josep
J
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015283:Citalopram / Q000627:therapeutic use; D003863:Depression / Q000139:chemically induced* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use
D018687:Antidepressive Agents, Second-Generation; D016898:Interferon-alpha; D015283:Citalopram; D012254:Ribavirin