Effect of pegylated interferon-a-2a treatment on mental health during recent hepatitis C virus infection

摘要

Background and Aim: Pegylated interferon (PEG-IFN) treatment for hepatitis C virus(HCV) infection has neuropsychiatric side effects. Data on the effect of HCV treatment onmental health among injecting drug users (IDUs) are limited. We assessed mental healthduring treatment of recently acquired HCV, within a predominantly IDU population.Methods: Participants with HCV received PEG-IFN-a-2a (180 mg/week) for 24 weeks;HCV/HIV received PEG-IFN with ribavirin. Depression was assessed using the Mini-International Neuropsychiatric Interview (MINI). Logistic regression was used to identifyfactors associated with depression at enrolment and during treatment. Also, the effect ofdepression prior to and during treatment on sustained virological response (SVR) wasassessed.Results: Of 163 participants, 111 received treatment (HCV, n = 74; HCV/HIV, n = 37),with 76% ever reporting IDU. At enrolment, 16% had depression (n = 25). In adjustedanalysis, depression at enrolment occurred less often in participants full-/part-timeemployed (adjusted odds ratio [AOR] 0.23; 95% confidence interval [CI]: 0.06, 0.82,P = 0.023) and more often in recent IDUs (AOR 3.04; 95% CI: 1.19, 7.72, P = 0.019).During treatment, 35% (n = 31) developed new-onset depression. In adjusted analysis,poorer social functioning (higher score) was associated with new-onset depression(score 9 vs score 17; OR 5.69; 95% CI: 1.61, 20.14, P = 0.007). SVR was similaramong participants with and without depression at enrolment (60% vs 61%, P = 0.951) andin those with and without new-onset depression (74% vs 63%, P = 0.293).Conclusions: Although depression at enrolment and during treatment was commonamong participants with recent HCV, neither influenced SVR. Participants with poor socialfunctioning may be most at risk of developing depression during HCV therapy