Co-infection with HIV associated with reduced vulnerability to symptoms of depression during antiviral treatment for hepatitis C

Psychiatry Res. 2017 Jul:253:150-157. doi: 10.1016/j.psychres.2017.03.049. Epub 2017 Mar 29.

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.

Keywords: Co-infection; Depression; HIV; Hepatitis C; Interferon; Triple therapy.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Coinfection / drug therapy
  • Coinfection / psychology*
  • Coinfection / virology
  • Depressive Disorder, Major / virology*
  • Drug Therapy, Combination
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / psychology*
  • HIV Infections / virology
  • Hepacivirus
  • Hepatitis C / drug therapy
  • Hepatitis C / psychology*
  • Hepatitis C / virology
  • Humans
  • Interferon-alpha / therapeutic use
  • Male
  • Middle Aged
  • Prospective Studies
  • Ribavirin / therapeutic use

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Ribavirin