Quality of life, depression, and cytokine patterns in patients with chronic hepatitis C treated with antiviral therapy.
OBJECTIVE
To evaluate the effect of chronic hepatitis C and antiviral therapy on health-related quality of life (HRQoL), depression symptoms and cytokine patterns.


METHODS
Twenty HCV+ patients treated with peginterferon plus ribavirin were enrolled in this cohort study and invited to complete SF-12 and BDI questionnaires prior to (T0) and at the end of the treatment (T1). HCV-RNA, serum levels of ALT, AST, haemoglobin, ferritin and IFN-gamma, TNF-alpha, IL-2, IL-4, IL-6 and IL-10 were evaluated at T0 and T1. The questionnaire results were correlated to biochemical and cytokine parameters.


RESULTS
Two patients (1%) dropped out and 18 HCV patients composed the final sample (11 males (61.1%); mean age 42.5+/-11.9 yr; mean disease duration 9.7+/-6.9 yr). Between T0 and T1 ALT (p=0.02), AST (p=0.052) HCV-RNA (P=0.0002) and haemoglobin levels decreased (p=0.0003), whereas ferritin level increased (P=0.003). Also, at T1 all cytokine levels were augmented. Regarding depression status, at T0 10 patients (55.5%) scored above to the BDI questionnaire (suggesting clinically significant depression), whereas at T1 14 patients scored 10 or above (77.7%). At T1 the mean BDI score increased, but this difference was not significant. Regarding HRQoL, the majority of patients had T0 summary scores < or = 50. At T1 HRQoL changed and scores decreased in 66.7% of the patients. A correlation was observed between the T0 level of ferritin and the amount of change in BDI and SF-12 mental score between T0 and T1 (Spearman rho = -0.56 and +0.61, respectively) and IL-4 level at T0 and the change in BDI and SF-12 mental scores (Spearman rho = -0.49 and +0.45, respectively).


CONCLUSIONS
BDI, SF-12, IL-4 and ferritin are good tools to predict the appearance of depressive symptoms and worsening of the quality of life in the HCV+ population.
Falasca
Katia
K
Clinic of Infectious Diseases, Dept. of Medicine and Science of Aging, University "G. D'Annunzio" School of Medicine, Via dei Vestini, 66100 Chieti, Italy.
Mancino
Paola
P
Ucciferri
Claudio
C
Dalessandro
Margherita
M
Manzoli
Lamberto
L
Pizzigallo
Eligio
E
Conti
Chiara M
CM
Vecchiet
Jacopo
J
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D003863:Depression / Q000378:metabolism* / Q000473:pathology; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012254:Ribavirin / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D000998:Antiviral Agents; D016207:Cytokines; D007376:Interleukin-2; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D012254:Ribavirin