title: Retrospective chart review to assess the relationship between depression and sustained virological response from interferon treatment for hepatitis C virus.
abstract: BACKGROUND
  Hepatitis C virus (HCV) is an infection that, if left untreated, may lead to liver complications and death. Current treatment requires peginterferon alfa (IFN) and ribavirin. Interferon can cause depression and irritability. The treatment goal is sustained virological response (SVR) and the impact of depression on SVR is currently inconclusive.
  
  
  OBJECTIVE
  The objective of this study was to compare SVR in patients with and without comorbid depression between different viral genotypes to determine if depressive symptoms impact SVR.
  
  
  METHODS
  In this retrospective chart review of HCV-treated patients, the Patient Health Questionnaire-9 (PHQ-9) scale for depression score was recorded to identify patients with depression versus patients without depression. Depression status was compared between SVR and non-SVR groups, as measured at 24 weeks posttreatment completion. Fisher exact or X(2) tests were used to evaluate differences between patients achieving SVR and those that did not. Known predictors of poor response were controlled with possible covariates in a multivariable analysis.
  
  
  RESULTS
  A total of 101 patients were enrolled in the study; 74 completed treatment and were included in the analysis. Sixty-five percent (17/26) of patients with depression achieved SVR and 54% (26/48) of patients without depression had SVR. SVR was achieved in 58.1% (43/74) of patients, and genotypes 1, 4 or 6 comprised 58.1% (43/74) of patients. We found 64.9% (48/74) had no depression, 20.3% (15/74) had baseline depression prior to IFN treatment, and 14.8% (11/74) had IFN-treatment-associated depression. The majority of patients were men (59.5%), more than 35 years old (91.9%), and Hispanic (55.4%). When these factors were controlled for, there was no statistical significant relationship between depression and SVR (P = 0.2784).
  
  
  CONCLUSIONS
  In these preliminary results, depression status did not impact SVR in this small, selected population of HCV-infected patients. A larger sample size is needed to achieve sufficient power in this population.
authors: University of Southern California School of Pharmacy, Los Angeles, California 90033, USA.
authors: Robin C
authors: RC
authors: Wackernah
authors: Mimi
authors: M
authors: Lou
authors: Susie H
authors: SH
authors: Park
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003863:Depression / Q000139:chemically induced* / Q000188:drug therapy / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a