title: Longitudinal effects of selective serotonin reuptake inhibitor therapy and cytokine-related depression on hepatitis C viral logs during antiviral therapy.
abstract: OBJECTIVE
  The aim of this study was to determine the longitudinal effects of selective serotonin reuptake inhibitor (SSRI) therapy and cytokine-related depression on levels of hepatitis C virus (HCV) during treatment with combination therapy.
  
  
  BACKGROUND
  Prior studies have investigated the association between cytokine-related depression and sustained virological response, but it is unknown whether anti-inflammatory properties of SSRIs used to treat cytokine-related depression inadvertently contravene proinflammatory properties of pegylated interferon (Peg-IFN), in effect reducing therapeutic efficacy.
  
  
  METHODS
  In a retrospective cohort design, patients being treated with Peg-IFN or interferon in combination with ribavirin at a gastroenterology clinic were followed from initiation of therapy until 24 weeks after the completion of therapy. Sustained virological response and rate of decline of HCV RNA levels were compared among patients with SSRI therapy and cytokine-related depression.
  
  
  RESULTS
  Selective serotonin reuptake inhibitor therapy and cytokine-related depression did not adversely impact the proportion of patients achieving sustained virological response. In a multivariate longitudinal analysis, the mean slope of HCV RNA levels declined faster over time in patients without cytokine-related depression in comparison to patients with cytokine-related depression (P = 0.05), and the mean slope of HCV RNA levels declined similarly over time in patients with and without SSRI therapy.
  
  
  CONCLUSIONS
  In this retrospective cohort, SSRI therapy did not interfere with immune activation dynamics of Peg-IFN/ribavirin, and patients without cytokine-related depression developed quicker responses and suppressed HCV replication more favorably over time.
authors.affiliation: From the *School of Social Work, University of Alabama, Tuscaloosa, AL; †Department of Epidemiology and Biostatistics, College of Public Health, and ‡School of Social Work, University of Georgia, Athens, GA.
authors.forename: Omar T
authors.initials: OT
authors.lastname: Sims
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Whalen
authors.forename: Larry G
authors.initials: LG
authors.lastname: Nackerud
authors.forename: Brian E
authors.initials: BE
authors.lastname: Bride
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood*; D003863:Depression / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007372:Interferons / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D007372:Interferons; D012367:RNA, Viral; D012254:Ribavirin; D017367:Selective Serotonin Reuptake Inhibitors