Does depression symptomatology affect medication compliance during the first weeks of anti-HCV therapy in intravenous drug users?
BACKGROUND
Psychological adverse effects in intravenous drug users represent a challenge in the management of anti-HCV therapy.


OBJECTIVE
To evaluate the depressive symptoms during the first weeks of anti-HCV therapy and to assess their impact on the early virological response and discontinuation of therapy.


METHODS
A prospective cohort study of HCV-infected drug addicts on a detoxification program at the onset of therapy with peg-interferon and ribavirin.


METHODS
A self-report screening of depression (Center for Epidemiological Studies-Depression Scale) and a questionnaire investigating treatment adherence and the presence of side effects were prospectively administered.


RESULTS
The mean baseline Center for Epidemiological Studies-Depression Scale score of the 43 subjects studied was 17.3. This value did not worsen significantly after 4 and 12 weeks of therapy. A higher depressive score at baseline neither significantly affected the early virological response, nor the early treatment discontinuation. Conversely, a higher symptoms score (HR 1.33; 95% CI, 1.02-1.71) was associated with a greater probability of early treatment discontinuation.


CONCLUSIONS
A depressive attitude should not be considered a contraindication to the treatment of HCV-infected drug addicts on the detoxification program in which they are monitored by a multidisciplinary team. Effective management of side effects could increase the treatment adherence during the first weeks of therapy and increase the possibility of an early virological response.
Guadagnino
V
V
Chair of Infectious Diseases, Postgraduate School of Infectious Diseases, University Magna Graecia of Catanzaro, Via Tommaso Campanella, 115, Catanzaro 88100, Italy. vguadagnino@unicz.it
Trotta
M P
MP
Carioti
J
J
Caroleo
B
B
Antinori
A
A
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D015819:Substance Abuse, Intravenous / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a