In a study conducted in the department of psychiatry and behavioral sciences at Emory University School of Medicine, researchers observed that patients who develop depressive symptoms during interferon-alpha plus ribavirin therapy were significantly less likely to have cleared the hepatitis C virus from their blood following six months of treatment.
According to one of the researchers, Dr Charles Raison, Peg-Intron, the current hepatitis C treatment produces a high rate of psychiatric side effects that have long been known to impede the therapy. Before, however, a primary concern was that depression would cause patients to stop taking the medication, whereas this new data suggests that the treatment outcome is affected even if depressed patients remain on the medication.
The study examined 103 participants who received pegylated interferon-alpha-2b plus ribavirin (PEG IFN/ribavirin). Only 34% of the patients who had a significant increase in depression cleared the hepatitis C virus from their blood at 24 weeks, as compared to 59% to 69% of patients with milder increases in depression.
The effect of depression on viral clearance persisted even after adjusting for factors known to affect treatment outcome, such as viral genotype, or whether medications had to be reduced.
“The findings of this study provide preliminary evidence that baseline mood state should be assessed in patients prior to commencing treatment,” said Dr Raison. “Significant deviations from this state may increase the likelihood of treatment failure. Moreover, these findings provide further support that the development of depression can have a negative impact on health outcomes in medically ill subjects.”
Researchers from the Rollins School of Public Health, Emory University and the Department of Medicine, Gasteroenterology and Hepatology, Weill Medical College of Cornell University were also involved in the study. The study was supported by grants from the National Institute of Mental Health, Schering-Plough, and the Centers for Disease Control and Prevention (CDC).