title: Co-infection with HIV associated with reduced vulnerability to symptoms of depression during antiviral treatment for hepatitis C.
abstract: In this prospective study, we examined new-onset major depressive disorder (MDD) and the differential expression of depressive symptoms in a sample of 132 HCV mono-infected and 40 HIV/HCV co-infected patients initiating pegylated interferon-based treatment, including protease inhibitor therapy. The semi-structured clinical interview (SCID-I) was used to assess MDD. Severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. Of the total sample, 60 patients (34.9%) developed SCID-I defined MDD during antiviral treatment. The proportion of HCV mono- and HIV/HCV patients developing MDD during treatment was not significantly different (37.9% vs. 25%; p=0.185). In both groups, there was a significant increase in HAMD total score from baseline to week 4, and a significant decrease between week 24 and 6 months post-treatment cessation. The greatest increase was observed in the symptoms of the neurovegetative syndrome. HCV mono-infected patients reported higher scores than co-infected patients, particularly impaired activity and somatic symptoms, but the differences were only significant at week 12. The finding that co-infected patients appear less vulnerable to the development of depressive symptoms during HCV treatment than HCV mono-infected patients warrants further exploration, including a thorough analysis of the biological and psychosocial factors associated with this emergence.
authors.affiliation: School of Psychology, University of Sussex, Brighton, United Kingdom; Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom. Electronic address: r.fialho@sussex.ac.uk.
authors.forename: Renata
authors.initials: R
authors.lastname: Fialho
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
authors.forename: Marco
authors.initials: M
authors.lastname: Pereira
authors.affiliation: Clinical Imaging Science Centre, University of Sussex, Brighton, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Harrison
authors.affiliation: School of Psychology, University of Sussex, Brighton, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rusted
authors.affiliation: Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom; Brighton and Sussex Medical School, Brighton, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Whale
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000188:drug therapy / Q000523:psychology* / Q000821:virology; D003865:Major Depressive Disorder / Q000821:virology*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology* / Q000821:virology; D016174:Hepacivirus; D006526:Hepatitis C / Q000188:drug therapy / Q000523:psychology* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin
keywords: Co-infection; Depression; HIV; Hepatitis C; Interferon; Triple therapy