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News

Depressive symptoms influence treatment course among Hep C patients

The most recent issue of the American Journal of Gastroenterology investigates changes in depressive symptoms and the impact on treatment course among Hepatitis C patients undergoing interferon-α and ribavirin therapy.

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Accounting for severity of depressive symptoms at baseline, Dr Megan Oser and colleagues from California, USA describe depressive symptom change over the course of antiviral treatment among patients with hepatitis C virus (HCV), and the relationship of such symptom change to treatment duration and response.

Depressive symptoms, measured with the Beck Depression Inventory (BDI), were examined prospectively among 129 HCV patients who endorsed minimal, mild, or moderate depressive symptoms prior to commencement of antiviral therapy.

Assessments were obtained at baseline, 2 weeks, 4 weeks, and thereafter at 4-week intervals until treatment was discontinued or completed.

The research team found that average depression score of the participants prior to commencing treatment was 7.4.

Depressive symptoms may worsen during antiviral therapy
American Journal of Gastroenterology

The team observed that depressive symptoms increased over the course of treatment, with average scores of 13 at the final assessment at the end of treatment.

The researchers observed that patients with mild depressive symptoms at baseline demonstrated the greatest increase, and the greatest change in depressive symptoms from baseline to treatment completion.

The team noted that patients who were minimally depressed at baseline completed the least amount of treatment.

Likewise, minimally depressed patients were less likely than mildly and moderately depressed patients to attain an antiviral treatment response.

Dr Oser's team concluded, "Depressive symptoms may worsen during antiviral therapy among patients with HCV."

"Notable changes in patients with subclinical depressive symptoms at baseline may be of significant concern, as the present work suggests that their depressive symptom changes are the most unstable."

"Thus, findings suggest that the degree of within treatment symptom change may be a more useful predictor of ability to tolerate treatment."

"As the findings of the present study are preliminary, we urge further research and replication before drawing firm conclusions."

Am J Gastroenterol 2011; 106:2123–2132
13 December 2011

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