title: Treatment-emergent depression and anxiety between peginterferon alpha-2a versus alpha-2b plus ribavirin for chronic hepatitis C.
abstract: BACKGROUND
  This study investigates differences in depression and anxiety between patients with chronic hepatitis C who are treated with peginterferon alpha-2a (PegIFN-α-2a) plus ribavirin and those who are treated with peginterferon alpha-2b (PegIFN-α-2b) plus ribavirin.
  
  
  METHODS
  In this 24 week, non-randomized, observational, prospective study, 55 patients with chronic hepatitis C were treated with PegIFN-α-2a plus ribavirin (Group 1), and 26 patients were treated with PegIFN-α-2b plus ribavirin (Group 2). All patients underwent assessment using the Hospital Anxiety and Depression Scale (HADS) at the baseline and at weeks 4, 12 and 24. Patients with depression scores (HADS-D) ≥ 8 and anxiety scores (HADS-A) ≥ 8 were defined as having depression and anxiety, respectively. The factors that were associated with depression and anxiety during the 24 week antiviral treatment were determined.
  
  
  RESULTS
  During the 24 week antiviral treatment, the proportion of patients with depression significantly increased over time in both groups (Group 1: p = 0.048; Group 2: p = 0.044). The proportion of patients with anxiety did not significantly change during the follow-up period in either group. Incidences of depression or anxiety did not differ significantly between Group 1 and Group 2. A history of alcohol use disorder was an independent predictor of depression at week 12 (p < 0.001) and week 24 (p < 0.001), and a poor virological response to treatment was associated with depression at week 24 (p = 0.029). Patients who had more physical comorbidities were more likely to suffer from anxiety at week 12 (p = 0.038).
  
  
  CONCLUSIONS
  This study did not identify significant differences in depression or anxiety between in patients with chronic hepatitis C who underwent a 24 week antiviral treatment regimen with PegIFN-α-2a plus ribavirin and those who underwent a regiment with PegIFN-α-2b plus ribavirin. Future research with larger samples and a randomized, controlled design are required to verify the findings in this study.
  
  
  BACKGROUND
  This clinical study has been registered at ClinicalTrials.gov. (Trial registration: NCT02943330 ).
authors.affiliation: Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Liang-Jen
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan.
authors.forename: Shuo-Wei
authors.initials: SW
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan.|Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chih-Ken
authors.initials: CK
authors.lastname: Chen
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan.
authors.forename: Cho-Li
authors.initials: CL
authors.lastname: Yen
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan.
authors.forename: Jia-Jang
authors.initials: JJ
authors.lastname: Chang
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan.
authors.forename: Tsung-Shih
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan.
authors.forename: Ching-Jung
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 222 Mai-Chin Road, Keelung, Taiwan. ronald@adm.cgmh.org.tw.
authors.forename: Rong-Nan
authors.initials: RN
authors.lastname: Chien
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001007:Anxiety / Q000139:chemically induced* / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003863:Depression / Q000139:chemically induced* / Q000453:epidemiology; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D015994:Incidence; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a
keywords: Anxiety; Depression; Hepatitis C; Interferon; Ribavirin