Quality of life, depression, and cytokine patterns in patients with chronic hepatitis C treated with antiviral therapy

Abstract

Clin Invest Med 2009; 32 (3): E212-E218. AbstractPurpose: To evaluate the effect of chronic hepatitis C and antiviral therapy on health-related quality of life (HRQoL), depression symptoms and cytokine patterns. Methods: Twenty HCV+ patients treated with peginterferon plus ribavirin were enrolled in this cohort study and invited to complete SF-12 and BDI questionnaires prior to (T0) and at the end of the treatment (T1). HCV-RNA, serum levels of ALT, AST, haemoglobin, ferritin and IFN-γ, TNF-α, IL-2, IL-4, IL-6 and IL-10 were evaluated at T0 and T1. The questionnaire results were correlated to biochemical and cytokine parameters. Results: Two patients (1%) dropped out and 18 HCV patients composed the final sample (11 males (61.1%); mean age 42.5±11.9 yr; mean disease duration 9.7±6.9 yr). Between T0 and T1 ALT (p=0.02), AST (p=0.052) HCV-RNA (P=0.0002) and haemoglobin levels decreased (p=0.0003), whereas ferritin level increased (P=0.003). Also, at T1 all cytokine levels were augmented. Regarding depression status, at T0 10 patients (55.5%) scored above to the BDI questionnaire (suggesting clinically significant depression), whereas at T1 14 patients scored 10 or above (77.7%). At T1 the mean BDI score increased, but this difference was not significant. Regarding HRQoL, the majority of patients had T0 summary scores ≤ 50. At T1 HRQoL changed and scores decreased in 66.7% of the patients.A correlation was observed between the T0 level of ferritin and the amount of change in BDI and SF-12 mental score between T0 and T1 (Spearman rho = -0.56 and +0.61, respectively) and IL-4 level at T0 and the change in BDI and SF-12 mental scores (Spearman rho = -0.49 and +0.45, respectively). Conclusion: BDI, SF-12, IL-4 and ferritin are good tools to predict the appearance of depressive symptoms and worsening of the quality of life in the HCV+ population.Hepatitis C virus (HCV) infection is the major cause of chronic liver disease worldwide leading 60% up to 80% of patients to develop a chronic infection 1 and is the primary indication for liver transplantion worldwide. This economic burden is multiplied by the dramatic impact of HCV on health related quality of life (HRQoL) resulting from complications of advanced liver disease. 2 On the other hand, evolving data indicate that HCV itself may diminish HRQoL in the absence of advanced liver disease 2 , perhaps as a result of extrahepatic symptoms related to HCV, cognitive dysfunction related to HCV, or a negative synergy between HCV and comorbid psychosocial disorders. 3 ORIGINAL RESEARCH

Mental Quality of Life Is Related to a Cytokine Genetic Pathway

“…Our primary finding, that the variation in mental QoL can be independently explained by cytokine-related genes, is in concordance with the emerging literature about the immunological basis of QoL-related symptoms and disorders such as depression and fatigue [29]–[35]. It is important to note that although related, depression, fatigue and QoL are distinct concepts.…”

Thyroid hormonal disturbances related to treatment of hepatitis C with interferon-alpha and ribavirin

“…The decreases in TT3 and TT4 levels may be related to interleukin-6 (IL-6). Previous studies have reported an increase in IL-6 serum levels with conventional and pegylated IFNα treatments 11,12. IL-6 reduces thyroperoxidase mRNA levels and TSH-stimulated thyroid hormone secretion separately from decreasing thyroid hormone binding proteins 13.…”

Humanistic and economic impacts of hepatitis C infection in the United States

“…For example, HCV patients with psychiatric illnesses [12][13][14] , fatigue 15 , and depression symptoms 16,17 have been shown to have worse health-related quality of life (HRQoL) than those without these comorbidities. Similarly, healthcare resource utilization in HCV patients is greater when HCV coexists with alcoholic liver disease.…”