Hepatitis C viral infection is a global health problem that affects approximately 4 million people in the United States.
Combination treatment with pegylated interferon-alpha plus ribavirin has been shown to be most effective in treating patients with chronic Hepatitis C.
Despite its efficacy, one of the most common side effects of this regimen is depression.
Interferon-alpha has been found to induce depression in chronic myelogenous leukemia, melanoma, and renal cell carcinoma.
Hepatitis C patients may be especially prone to develop interferon-induced depression.
Dr Gregory Asnis and colleagues conducted a review of the differences between interferon-alpha and interferon-beta.
| Mechanisms for the depression include the actions of monoamines, and nitric oxide|
|Journal of Clinical Gastroenterology|
The team assessed whether pegylation of interferon gives rise to a treatment with reduced potential to induce depressive symptoms.
The research team also gave consideration to evidence showing that treatment with ribavirin may contribute to interferon-induced depression.
The team noted that thyroid disorders and anemia have also been associated with interferon exposure.
These other conditions may account for some incidences of depression in Hepatitis C patients.
The researchers found that prior psychiatric and mood disorders, especially major depressive disorder, contribute to depression during treatment.
The team provides a brief description of potential biological mechanisms of interferon-induced depression.
The mechanisms include the actions of monoamines, hypothalamic-pituitary-adrenocortical axis, cytokines, peptidases, intercellular adhesion molecule-1, and nitric oxide.
The team discusses using antidepressants as a preventative versus restorative treatment.
In addition, the researchers comment on risks of using antidepressants in this patient population.
Dr Asnis' team commented, “Prior psychiatric and mood disorders, especially major depressive disorder, prior to interferon treatment, contribute to depression during treatment.”
“We discuss the risks of using antidepressants in this patient population.”