Depressão no Tratamento da Hepatite C

Abstract

Depressive symptoms have been frequently observed in association with immune activation. To prospectively evaluate, depressive symptoms and risk factors for major depression in patients with hepatitis C virus (HCV) treated with antiviral combined therapy. This study is a convenience cohort that evaluated 50 patients with HCV by the structured diagnostic interview - Mini International Neuropsychiatric Interview (MINI) to screen for depressive symptoms before antiviral combined therapy, and in the follow-up visits (4 and 12th week). Laboratorial analysis were performed during the follow-up. The study was approved by the University s Ethics Committee (151.642). We evaluated 50 patients, in which prevalence of genotype 1 was 42%. Pegylated interferon alpha (IFN-α) and ribavirin was the most prevalent treatment used for HCV (86%). During the follow-up of patients, treatment for HCV increases the risk of depression in the 4th week (43.5.9%), but not at 12th week (30.7%) treatment compared with the baseline (25.6%) (p=0.04). We found differences between the prevalences of depression and genotypes of the virus in regard to time of the follow-up with higher odds ratio in the 4th week (OR=2.2) compared to baseline and 12th week (OR=1.8) using pairwise comparisons with Bonferroni adjustment (p=0.03). Also, patients with genotype 2 and 3 had significantly lower odds of presenting depression compared genotype 1 (p≤0.05). However, the average score on the BDI-II did not differ in the follow-up.This study provide evidence of an association between HCV genotype and major depression. During the follow-up, depressive symptoms increase in 4th week, corresponding to conditions of immune activation. Major depression in HCV patients influence their health-related quality of life and their adherence to antiviral treatment 8 being important screening programmes, for early recognition and treatment of interferon-induced depression