Impact of depressive symptoms and their treatment on completing antiviral treatment in patients with chronic hepatitis C

Stanley S. Liu, Terry D. Schneekloth, Jayant A. Talwalkar, W. Ray Kim, John J. Poterucha, Michael R. Charlton, Russell H. Wiesner, John B. Gross

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background/Goals: Interferon-induced depression affects 20% to 40% of patients treated for chronic hepatitis C virus (HCV). The aim of our study was to examine the influence of antidepressant treatment and whether this improves the likelihood of completing therapy. Methods: One hundred randomly selected patients with chronic HCV undergoing antiviral therapy at a single center were identified. Patients were categorized as Group 1 (no depressive symptoms during treatment), Group 2 (depressive symptoms without antidepressant therapy), Group 3 (preexisting or prophylactic antidepressants before therapy), and Group 4 (on-demand antidepressant therapy for depressive symptoms). Results: Mean age was 49 years with 72% men. Genotype 1 infection was noted in 65% of patients, and the mean pretreatment HCV RNA level was 1,419,919 IU. Patients without earlier depression receiving on-demand therapy (Group 4) had a significantly higher rate of antiviral treatment completion compared with Group 3 (92% vs. 52%; P=0.01). Patients in groups 1 and 4 with no baseline history of depression had similar treatment completion rates. No significant relationship between the use of antidepressant therapy, SVR or premature cessation of therapy was observed. Conclusions: Preexisting depression was associated with lower antiviral treatment completion rates despite the use of prophylactic antidepressant therapy. In patients without preexisting depression, however, on-demand antidepressant therapy for depressive symptoms was strongly associated with the highest treatment completion rates in the cohort. Antidepressant therapy for new or worsening depressive symptoms independent of baseline depression status did not affect the probability of achieving SVR or stopping treatment prematurely.

Original languageEnglish (US)
JournalJournal of Clinical Gastroenterology
Volume44
Issue number8
DOIs
StatePublished - Sep 2010

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Chronic Hepatitis C
Antiviral Agents
Depression
Antidepressive Agents
Therapeutics
Group Psychotherapy
Hepacivirus
Interferons

Keywords

  • antidepressant treatment
  • chronic hepatitis C
  • depression
  • sustained viral response
  • treatment adherence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Impact of depressive symptoms and their treatment on completing antiviral treatment in patients with chronic hepatitis C. / Liu, Stanley S.; Schneekloth, Terry D.; Talwalkar, Jayant A.; Kim, W. Ray; Poterucha, John J.; Charlton, Michael R.; Wiesner, Russell H.; Gross, John B.

In: Journal of Clinical Gastroenterology, Vol. 44, No. 8, 09.2010.

Research output: Contribution to journalArticle

Liu, Stanley S. ; Schneekloth, Terry D. ; Talwalkar, Jayant A. ; Kim, W. Ray ; Poterucha, John J. ; Charlton, Michael R. ; Wiesner, Russell H. ; Gross, John B. / Impact of depressive symptoms and their treatment on completing antiviral treatment in patients with chronic hepatitis C. In: Journal of Clinical Gastroenterology. 2010 ; Vol. 44, No. 8.
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abstract = "Background/Goals: Interferon-induced depression affects 20{\%} to 40{\%} of patients treated for chronic hepatitis C virus (HCV). The aim of our study was to examine the influence of antidepressant treatment and whether this improves the likelihood of completing therapy. Methods: One hundred randomly selected patients with chronic HCV undergoing antiviral therapy at a single center were identified. Patients were categorized as Group 1 (no depressive symptoms during treatment), Group 2 (depressive symptoms without antidepressant therapy), Group 3 (preexisting or prophylactic antidepressants before therapy), and Group 4 (on-demand antidepressant therapy for depressive symptoms). Results: Mean age was 49 years with 72{\%} men. Genotype 1 infection was noted in 65{\%} of patients, and the mean pretreatment HCV RNA level was 1,419,919 IU. Patients without earlier depression receiving on-demand therapy (Group 4) had a significantly higher rate of antiviral treatment completion compared with Group 3 (92{\%} vs. 52{\%}; P=0.01). Patients in groups 1 and 4 with no baseline history of depression had similar treatment completion rates. No significant relationship between the use of antidepressant therapy, SVR or premature cessation of therapy was observed. Conclusions: Preexisting depression was associated with lower antiviral treatment completion rates despite the use of prophylactic antidepressant therapy. In patients without preexisting depression, however, on-demand antidepressant therapy for depressive symptoms was strongly associated with the highest treatment completion rates in the cohort. Antidepressant therapy for new or worsening depressive symptoms independent of baseline depression status did not affect the probability of achieving SVR or stopping treatment prematurely.",
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AU - Kim, W. Ray

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AU - Charlton, Michael R.

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