Angelino Andrew F, Treisman Glenn J
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Int Rev Psychiatry. 2005 Dec;17(6):471-6. doi: 10.1080/02646830500381567.
More than 4 million people are currently infected with Hepatitis C an RNA virus that may ultimately result in complete hepatic failure and is often a silent infection until late in the course of disease. Hepatitis C patients have increased rates of major depression (as well as substance abuse) and treatment of hepatitis with interferon, the current standard treatment, provokes episodes of depression in as many as a third of patients treated. Immune-dysfunction mediated mechanisms for the depression in these patients have been proposed and have increasing experimental support. The resulting depression has interfered with treatment for many patients, but several standard treatments for depression have been shown to be effective in patients with interferon-associated depression, suggesting that this should not be a barrier to effective treatment. In this paper, we review the evidence for associations between depression and Hepatitis C and interferon treatment, as well as the evidence supporting an immune mechanism for the association, and finally the data showing effective treatment and recommendations for prophylactic use of anti-depressants.
目前有超过400万人感染了丙型肝炎病毒，这是一种RNA病毒，最终可能导致完全肝衰竭，并且在疾病进程晚期之前通常是一种隐性感染。丙型肝炎患者患重度抑郁症（以及药物滥用）的几率更高，而目前的标准治疗方法——用干扰素治疗肝炎，会使多达三分之一接受治疗的患者出现抑郁发作。已经提出了这些患者抑郁的免疫功能障碍介导机制，并且有越来越多的实验支持。由此产生的抑郁已经干扰了许多患者的治疗，但几种标准的抑郁症治疗方法已被证明对患有干扰素相关性抑郁的患者有效，这表明这不应成为有效治疗的障碍。在本文中，我们回顾了抑郁症与丙型肝炎及干扰素治疗之间关联的证据，以及支持这种关联的免疫机制的证据，最后回顾了显示有效治疗的数据以及抗抑郁药预防性使用的建议。
