title: Symptoms of anxiety and depression are frequent in patients with acute hepatitis C and are not associated with disease severity.
abstract: OBJECTIVE
  Neuropsychiatric symptoms of hepatitis C virus (HCV) infection and during peginterferon α therapy have been investigated in the chronic stage of the infection, but have not been described during the acute phase of the disease so far. We therefore evaluated anxiety and depression in patients with acute hepatitis C by the Hospital Anxiety and Depression Scale (HADS) within a clinical trial.
  
  
  METHODS
  Data were analysed from the German Hep-Net Acute HCV-III study. Anxiety and depression were characterized by an anxiety (HADS-A) and a depression subscale (HADS-D). More than eight points in each subscale were considered clinically relevant. Data were prospectively collected at baseline, end of treatment and at the end of the study.
  
  
  RESULTS
  At baseline, a HADS-A above eight points was observed significantly more frequently than a HADS-D above eight points [n=23/103 (22%) vs. n=12/103 (12%); P=0.041].A pathological HADS-A or HADS-D score did not correlate with age, sex, IL28B genotype, the probable mode of infection, HCV genotype or severity of disease as investigated by alanine aminotransferase and bilirubin levels.Antiviral therapy did not influence anxiety as 12/50 (24%) of patients had HADS-A above 8 at the end of therapy. The proportion of patients with HADS-D above eight points increased from 12% at baseline to 24% (n=12/50) at the end of therapy (P=0.06). HADS results were not associated with lost to follow-up or sustained virological response rates.
  
  
  CONCLUSIONS
  HADS data in acute HCV infection indicate that anxiety and depression do not correlate with severity of the disease, mode of acquisition, lost to follow-up and sustained virological response rates.
authors.affiliation: aHep-Net: German Network of Competence on Viral Hepatitis bDepartment of Gastroenterology, Hepatology and Endocrinology cDepartment of Biometry dDiagnostic Laboratory, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover eMedical Department II, Institute for Immunology, Ludwig Maximilians University, Munich fDepartment of Internal Medicine, Division of Gastroenterology and Rheumatology, University of Leipzig, Leipzig gI. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg hI. Department of Internal Medicine, University Medical Center, Mainz iDepartment of Internal Medicine I, University of Bonn, Bonn jDepartment of Medicine, Christian Albrechts University, Kiel kDepartment of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Deterding
authors.forename: Norbert
authors.initials: N
authors.lastname: Grüner
authors.forename: Peter
authors.initials: P
authors.lastname: Buggisch
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Ulrich
authors.initials: U
authors.lastname: Spengler
authors.forename: Holger
authors.initials: H
authors.lastname: Hinrichsen
authors.forename: Thomas
authors.initials: T
authors.lastname: Berg
authors.forename: Andrej
authors.initials: A
authors.lastname: Potthoff
authors.forename: Anika
authors.initials: A
authors.lastname: Grohennig
authors.forename: Armin
authors.initials: A
authors.lastname: Koch
authors.forename: Helmut
authors.initials: H
authors.lastname: Diepolder
authors.forename: Stefan
authors.initials: S
authors.lastname: Lüth
authors.forename: Sandra
authors.initials: S
authors.lastname: Feyerabend
authors.forename: Maria C
authors.initials: MC
authors.lastname: Jung
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rogalska-Taranta
authors.forename: Verena
authors.initials: V
authors.lastname: Schlaphoff
authors.forename: Markus
authors.initials: M
authors.lastname: Cornberg
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
authors.forename: Johannes
authors.initials: J
authors.lastname: Wiegand
mesh_terms: D000208:Acute Disease; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents