Fumaz C R, Muñoz-Moreno J A, Ballesteros A L, Paredes R, Ferrer M J, Salas A, Fuster D, Masmitjà E, Pérez-Alvarez N, Gómez G, Tural C, Clotet B
Universitat Autònoma de Barcelona, Barcelona, Spain.
AIDS Care. 2007 Jan;19(1):138-45. doi: 10.1080/09540120600645539.
This is a prospective observational comparative 48-week study to assess the impact of the different types of Peg-IFN on depressive and neuropsychiatric symptoms during treatment in HIV-HCV coinfected patients. Thirty-one patients treated with Peg-IFN alpha-2b 1.5 microg/kg/w plus ribavirine (RBV) (Peg-IFN alpha-2b Group) and 32 patients receiving Peg-IFN alpha-2a 180 microg/w plus RBV (Peg-IFN alpha-2a Group) were included. Depressive and neuropsychiatric symptoms, quality of life and adherence were assessed. Fifteen subjects (23%) discontinued therapy (p = 0.3, between groups). Overall, 37 patients presented mild to moderate depressive symptoms, 9 moderate to severe and 3 severe, without differences between groups. Patients in Peg-IFN alpha-2b reported higher fatigue and dizziness at weeks 12 (p < 0.05) and 24 (p < 0.05), and irritability and memory loss at week 24 (p < 0.05) with respect to Peg-IFN alpha-2a Group. At week 12, role functioning, general health perception, vitality, emotional role, mental health and the summary areas of physical health and mental health were lower in Peg-IFN alpha-2b Group (p < 0.05). The same was observed in physical functioning (p = 0.05) and role functioning, general health perception, emotional role and mental health (p < 0.001) at week 24. Three months after finishing treatment, no patient had depressive or neuropsychiatric symptoms, and quality of life improved. Antiretroviral adherence was low but adherence to anti-HCV therapy remained high in both groups. According to our data, Peg-IFN alpha-2a and Peg-IFN alpha-2b exert a similar impact on the overall rate of depressive symptoms, although patients treated with Peg-IFN alpha-2a experience less fatigue and fewer neuropsychiatric symptoms and a lower impairment in their physical and mental quality of life.
这是一项前瞻性观察性对比48周研究，旨在评估不同类型聚乙二醇干扰素（Peg-IFN）对HIV-HCV合并感染患者治疗期间抑郁和神经精神症状的影响。纳入了31例接受聚乙二醇干扰素α-2b 1.5μg/kg/周加利巴韦林（RBV）治疗的患者（聚乙二醇干扰素α-2b组）和32例接受聚乙二醇干扰素α-2a 180μg/周加RBV治疗的患者（聚乙二醇干扰素α-2a组）。评估了抑郁和神经精神症状、生活质量及依从性。15名受试者（23%）中断治疗（组间p = 0.3）。总体而言，37例患者出现轻度至中度抑郁症状，9例为中度至重度，3例为重度，组间无差异。与聚乙二醇干扰素α-2a组相比，聚乙二醇干扰素α-2b组患者在第12周（p < 0.05）和第24周（p < 0.05）报告有更高的疲劳和头晕发生率，在第24周有更高的易怒和记忆力减退发生率（p < 0.05）。在第12周，聚乙二醇干扰素α-2b组的角色功能、总体健康感知、活力、情感角色、心理健康以及身体健康和心理健康的总结领域得分较低（p < 0.05）。在第24周，身体功能（p = 0.05）以及角色功能、总体健康感知、情感角色和心理健康（p < 0.001）方面也观察到同样情况。治疗结束三个月后，无患者有抑郁或神经精神症状，生活质量得到改善。抗逆转录病毒治疗的依从性较低，但两组抗HCV治疗的依从性仍然较高。根据我们的数据，聚乙二醇干扰素α-2a和聚乙二醇干扰素α-2b对抑郁症状的总体发生率影响相似，但接受聚乙二醇干扰素α-2a治疗的患者疲劳更少、神经精神症状更少，其身心健康质量受损程度更低。
