Reichenberg Abraham, Gorman Jack M, Dieterich Douglas T
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
AIDS. 2005 Oct;19 Suppl 3:S174-8. doi: 10.1097/01.aids.0000192087.64432.ae.
This study assessed the rates and course of depressive symptomatology and neurocognitive deficits in hepatitis C virus (HCV) patients undergoing interferon treatment, and explored possible predictors of depression and neurocognitive deficits.
In order to obtain objective assessments of depression, and to evaluate cognitive impairment, a 72-week prospective study, comprising 48 weeks of treatment and 24 weeks of post-treatment follow-up was utilized.
A total of 50 HCV patients were assessed at baseline, and 14 times during pegylated interferon plus ribavirin treatment. Patients were also assessed on four timepoints after the termination of treatment. All patients have previously been treated for hepatitis C infection with interferon and were judged to be treatment resistant in these treatments. Depression was assessed using the Center for Epidemiological Studies Depression (CES-D) questionnaire, and patients were interviewed regarding problems with memory, attention and concentration.
Eighty-two per cent of interferon-treated patients developed severe enough depressive symptoms to meet the CES-D criteria for possible major depressive disorder (MDD). Possible MDD onset was most frequent by the first week of treatment, and almost all possible MDD cases were observed by week 8. More severe depressive symptoms at baseline were associated with higher depressive symptoms during interferon treatment. Thirty per cent of patients complained about cognitive problems. In half of these patients cognitive impairments were still reported after the termination of treatment. There was no association between depression during interferon treatment and subjective cognitive complaints.
The findings suggest that depression and cognitive impairments are frequent and persistent side-effects of interferon treatment in treatment-resistant patients.
本研究评估了接受干扰素治疗的丙型肝炎病毒（HCV）患者的抑郁症状发生率及病程以及神经认知缺陷情况，并探讨了抑郁和神经认知缺陷的可能预测因素。
为了获得对抑郁的客观评估并评估认知障碍，采用了一项为期72周的前瞻性研究，包括48周的治疗期和24周的治疗后随访期。
共对50例HCV患者在基线时进行了评估，并在聚乙二醇干扰素加利巴韦林治疗期间评估了14次。在治疗结束后的四个时间点也对患者进行了评估。所有患者此前均接受过干扰素治疗丙型肝炎感染，且在这些治疗中被判定为治疗抵抗。使用流行病学研究中心抑郁量表（CES-D）问卷评估抑郁情况，并就记忆、注意力和专注力问题对患者进行访谈。
82%接受干扰素治疗的患者出现了严重到足以符合CES-D标准的抑郁症状，可能患有重度抑郁症（MDD）。可能的MDD发病在治疗的第一周最为频繁，几乎所有可能的MDD病例在第8周时都已出现。基线时更严重的抑郁症状与干扰素治疗期间更高的抑郁症状相关。30%的患者抱怨存在认知问题。在这些患者中，一半在治疗结束后仍报告有认知障碍。干扰素治疗期间的抑郁与主观认知主诉之间没有关联。
研究结果表明，抑郁和认知障碍是干扰素治疗耐药患者常见且持续存在的副作用。
