Antiviral Completion Rates and Sustained Viral Response in Hepatitis C Patients With and Without Preexisting Major Depressive Disorder

Hauser, Péter; Morasco, Benjamin J.; Linke, Alex; Bjornson, Dannell; Ruimy, Samantha; Matthews, Annette M.; Rifai, Aly; Indest, David W.; Loftis, Jennifer M.

doi:10.1176/appi.psy.50.5.500

Cited by 18 publications

(13 citation statements)

References 25 publications

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“…A prospective study (n = 394) analyzed the relationship between baseline and new-onset depression and treatment outcomes, and SVR rates did not differ between patients who developed MDD and those who did not (6). Results from our retrospective cohort study support and extend these findings by comparing rates of antiviral therapy completion and SVR between patients with HCV and MDD versus those without MDD (7). We found that the MDD group had completion and SVR rates similar to patients without MDD.…”

supporting

confidence: 63%

Depression and antiviral response to interferon-based therapy for hepatitis C virus infection

2011

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supporting

confidence: 63%

Depression and antiviral response to interferon-based therapy for hepatitis C virus infection

2011

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“…As a result of this productivity and new information, we now know that patients with diagnoses of major depressive disorder should not necessarily be excluded from treatment [54]. Screening and monitoring of neuropsychiatric symptoms during the course of therapy are strongly recommended[2,55].…”

Section: Discussionmentioning

confidence: 99%

Vulnerability to somatic symptoms of depression during interferon-alpha therapy for hepatitis C: A 16-week prospective study

Loftis

Patterson

Wilhelm

et al. 2013

Journal of Psychosomatic Research

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Objective This study evaluated the distinctive clinical and biological manifestations of depressive symptom subtypes (i.e., cognitive–affective and somatic) in Veterans with hepatitis C viral infection (HCV) before and during interferon-alpha (IFN) based antiviral therapy. Methods Thirty-two Veterans with HCV and no prior history of IFN therapy were followed prospectively during the first 16 weeks of therapy to evaluate depressive symptoms and to determine if baseline cytokine and serotonin levels predicted subsequent changes in depressive scores. Results IFN therapy resulted in a significant increase in total depressive symptoms from baseline (week 0) to week 16, with neurovegetative and somatic symptoms of depression including loss of appetite, fatigue and irritability increasing within the first two weeks of therapy and continuing to increase throughout IFN therapy. When depressive symptoms were evaluated using a two-factor (i.e., Cognitive–Affective and Somatic) model, the Cognitive–Affective factor score did not change significantly following IFN therapy initiation, while the Somatic factor score showed a significant increase from week 0 to week 16. Veterans with the largest increases in somatic symptoms from week 0 to week 2 had significantly higher levels of tumor necrosis factor-alpha (TNF-α) and lower levels of serotonin at baseline, as compared to Veterans with minimal or no increase in somatic symptoms. Conclusion Somatic symptoms of depression can be significantly exacerbated during IFN therapy and may be predicted by higher TNF-α levels and lower serotonin levels at baseline.

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“…Although HCV is treatable in some patients, there is no vaccine and the current treatment [ i.e ., combination therapy with pegylated interferon-alpha (IFN-α) and ribavirin] has only limited efficacy. Sustained viral response (SVR) is typically achieved in only about 40–50% of those with HCV genotype 1 and 75–80% of those with HCV genotypes 2/3[2]. Thus, considerable effort has been devoted to identifying predictors of viral clearance for patients with HCV.…”

Section: Introductionmentioning

confidence: 99%

Serum Serotonin Levels are Associated with Antiviral Therapy Outcomes in Patients with Chronic Hepatitis C

Loftis¹,

Morasco²,

Menasco³

et al. 2013

TOIDJ

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The role of serotonin in contributing to viral clearance has not been investigated in patients with chronic hepatitis C (HCV). In this prospective study we collected blood samples from 39 patients prior to and during antiviral therapy. Participants completed mood rating scales to monitor psychiatric symptoms, and serum serotonin and tryptophan levels were measured. Significant differences in serotonin levels were found between patients who achieved sustained viral responses (SVRs) and those who did not. Regression analysis revealed that serotonin was the only variable with a statistically significant relationship with antiviral therapy outcomes, even after controlling for other variables known to be associated with outcomes. Baseline serum serotonin levels, in combination with other variables such as degree of liver fibrosis, may be clinically useful for identifying patients in whom HCV can be cleared by antiviral therapy. Additional clinical predictors that could forecast treatment success are needed so that interventions to improve SVR rates, and reduce side effects, can be developed.

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Antiviral Completion Rates and Sustained Viral Response in Hepatitis C Patients With and Without Preexisting Major Depressive Disorder

Abstract: Patients with MDD can be safely and effectively treated with antiviral therapy.

Cited by 18 publications

References 25 publications

Depression and antiviral response to interferon-based therapy for hepatitis C virus infection

Depression and antiviral response to interferon-based therapy for hepatitis C virus infection

Vulnerability to somatic symptoms of depression during interferon-alpha therapy for hepatitis C: A 16-week prospective study

Serum Serotonin Levels are Associated with Antiviral Therapy Outcomes in Patients with Chronic Hepatitis C

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