title: Effect of pegylated interferon-α-2a treatment on mental health during recent hepatitis C virus infection.
abstract: OBJECTIVE
  Pegylated interferon (PEG-IFN) treatment for hepatitis C virus (HCV) infection has neuropsychiatric side effects. Data on the effect of HCV treatment on mental health among injecting drug users (IDUs) are limited. We assessed mental health during treatment of recently acquired HCV, within a predominantly IDU population.
  
  
  METHODS
  Participants with HCV received PEG-IFN-α-2a (180 µg/week) for 24 weeks; HCV/HIV received PEG-IFN with ribavirin. Depression was assessed using the Mini-International Neuropsychiatric Interview (MINI). Logistic regression was used to identify factors associated with depression at enrolment and during treatment. Also, the effect of depression prior to and during treatment on sustained virological response (SVR) was assessed.
  
  
  RESULTS
  Of 163 participants, 111 received treatment (HCV, n = 74; HCV/HIV, n = 37), with 76% ever reporting IDU. At enrolment, 16% had depression (n = 25). In adjusted analysis, depression at enrolment occurred less often in participants full-/part-time employed (adjusted odds ratio [AOR] 0.23; 95% confidence interval [CI]: 0.06, 0.82, P = 0.023) and more often in recent IDUs (AOR 3.04; 95% CI: 1.19, 7.72, P = 0.019). During treatment, 35% (n = 31) developed new-onset depression. In adjusted analysis, poorer social functioning (higher score) was associated with new-onset depression (score ≤ 9 vs score ≥ 17; OR 5.69; 95% CI: 1.61, 20.14, P = 0.007). SVR was similar among participants with and without depression at enrolment (60% vs 61%, P = 0.951) and in those with and without new-onset depression (74% vs 63%, P = 0.293).
  
  
  CONCLUSIONS
  Although depression at enrolment and during treatment was common among participants with recent HCV, neither influenced SVR. Participants with poor social functioning may be most at risk of developing depression during HCV therapy.
authors.affiliation: The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia. msalehialavi@kirby.unsw.edu.au
authors.forename: Maryam
authors.initials: M
authors.lastname: Alavi
authors.forename: Jason
authors.initials: J
authors.lastname: Grebely
authors.forename: Gail V
authors.initials: GV
authors.lastname: Matthews
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos
authors.forename: Barbara
authors.initials: B
authors.lastname: Yeung
authors.forename: Carolyn
authors.initials: C
authors.lastname: Day
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Lloyd
authors.forename: Ingrid
authors.initials: I
authors.lastname: Van Beek
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Dore
authors.forename: Paul S
authors.initials: PS
authors.lastname: Haber
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D060085:Coinfection / Q000523:psychology; D003863:Depression / Q000139:chemically induced* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D055030:Drug Users / Q000523:psychology; D004651:Employment / Q000523:psychology; D005260:Female; D006679:HIV Seropositivity / Q000523:psychology; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D058992:Social Participation / Q000523:psychology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a