title: Impact on adherence and sustained virological response of psychiatric side effects during peginterferon and ribavirin therapy for chronic hepatitis C.
abstract: BACKGROUND
  The psychiatric side effects of interferon, often responsible for dose reduction or treatment discontinuation, represent a major limitation in the treatment of chronic hepatitis C (CHC).
  
  
  OBJECTIVE
  To prospectively assess the impact on adherence and sustained virological response (SVR) of the occurrence of psychiatric side effects during peginterferon and ribavirin therapy for CHC.
  
  
  METHODS
  Ninety-eight consecutive treatment-naïve CHC patients receiving a standard course of peginterferon plus ribavirin were systematically screened for psychiatric side effects, using DSM-IV, at baseline and both during and after treatment.
  
  
  RESULTS
  Psychiatric side effects occurred in 38 patients (39%), mostly within the first 12 weeks (87%), and always consisted of mood disorders. Overall, 68% of patients achieved an SVR (71% of patients with mood disorders and 68% of those without; P = N.S.). Peginterferon and ribavirin dose reductions did not differ between patients with mood disorders and those without (46% vs. 37%, respectively; P = N.S. and 13% vs. 22%, respectively; P = N.S.). Anti-viral therapy had to be discontinued in four patients (nonresponse: two, hyperthyroidism: one, psychiatric event: one).
  
  
  CONCLUSIONS
  Early detection and appropriate management of psychiatric side effects during peginterferon and ribavirin therapy for CHC allow optimizing adherence and virological efficacy.
authors.affiliation: Service d'Hépato-Gastroenterologie, C.H.U. Bordeaux, Hôpital Haut Lévêque, Avenue Magellan, 33604 Pessac, France. laurent.castera@chu-bordeaux.fr
authors.forename: L
authors.initials: L
authors.lastname: Castera
authors.forename: A
authors.initials: A
authors.lastname: Constant
authors.forename: C
authors.initials: C
authors.lastname: Henry
authors.forename: P
authors.initials: P
authors.lastname: Champbenoit
authors.forename: P-H
authors.initials: PH
authors.lastname: Bernard
authors.forename: V
authors.initials: V
authors.lastname: De Ledinghen
authors.forename: J
authors.initials: J
authors.lastname: Demotes-Mainard
authors.forename: P
authors.initials: P
authors.lastname: Couzigou
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000139:chemically induced / Q000821:virology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced* / Q000523:psychology / Q000821:virology; D010349:Patient Compliance / Q000523:psychology*; D011092:Polyethylene Glycols; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects*; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b