University of Southern California School of Pharmacy, Los Angeles, California 90033, USA.
Clin Ther. 2011 Oct;33(10):1400-5. doi: 10.1016/j.clinthera.2011.09.002. Epub 2011 Oct 7.
Hepatitis C virus (HCV) is an infection that, if left untreated, may lead to liver complications and death. Current treatment requires peginterferon alfa (IFN) and ribavirin. Interferon can cause depression and irritability. The treatment goal is sustained virological response (SVR) and the impact of depression on SVR is currently inconclusive.
The objective of this study was to compare SVR in patients with and without comorbid depression between different viral genotypes to determine if depressive symptoms impact SVR.
In this retrospective chart review of HCV-treated patients, the Patient Health Questionnaire-9 (PHQ-9) scale for depression score was recorded to identify patients with depression versus patients without depression. Depression status was compared between SVR and non-SVR groups, as measured at 24 weeks posttreatment completion. Fisher exact or X(2) tests were used to evaluate differences between patients achieving SVR and those that did not. Known predictors of poor response were controlled with possible covariates in a multivariable analysis.
A total of 101 patients were enrolled in the study; 74 completed treatment and were included in the analysis. Sixty-five percent (17/26) of patients with depression achieved SVR and 54% (26/48) of patients without depression had SVR. SVR was achieved in 58.1% (43/74) of patients, and genotypes 1, 4 or 6 comprised 58.1% (43/74) of patients. We found 64.9% (48/74) had no depression, 20.3% (15/74) had baseline depression prior to IFN treatment, and 14.8% (11/74) had IFN-treatment-associated depression. The majority of patients were men (59.5%), more than 35 years old (91.9%), and Hispanic (55.4%). When these factors were controlled for, there was no statistical significant relationship between depression and SVR (P = 0.2784).
In these preliminary results, depression status did not impact SVR in this small, selected population of HCV-infected patients. A larger sample size is needed to achieve sufficient power in this population.
丙型肝炎病毒（HCV）是一种感染，如果不进行治疗，可能会导致肝脏并发症和死亡。目前的治疗需要聚乙二醇干扰素 alfa（IFN）和利巴韦林。干扰素会引起抑郁和易怒。治疗目标是持续病毒学应答（SVR），目前抑郁对 SVR 的影响尚无定论。
本研究旨在比较不同病毒基因型中伴有和不伴有共病抑郁的患者的 SVR，以确定抑郁症状是否影响 SVR。
在这项 HCV 治疗患者的回顾性图表研究中，记录了患者健康问卷-9（PHQ-9）抑郁量表评分，以确定有抑郁症状的患者和无抑郁症状的患者。在治疗完成后 24 周时，根据 SVR 和非 SVR 组的结果比较抑郁状态。Fisher 确切检验或 X(2)检验用于评估 SVR 患者和未达到 SVR 患者之间的差异。在多变量分析中，用可能的协变量控制了不良反应的已知预测因素。
共有 101 名患者入组该研究；74 名完成治疗并纳入分析。有抑郁症状的患者中 65%（17/26）达到 SVR，无抑郁症状的患者中 54%（26/48）达到 SVR。74 名患者中有 58.1%（43/74）达到 SVR，基因型 1、4 或 6 占 58.1%（43/74）。我们发现 64.9%（48/74）无抑郁，20.3%（15/74）在 IFN 治疗前有基线抑郁，14.8%（11/74）有 IFN 治疗相关性抑郁。大多数患者为男性（59.5%），年龄超过 35 岁（91.9%），为西班牙裔（55.4%）。当控制这些因素时，抑郁与 SVR 之间没有统计学上的显著关系（P = 0.2784）。
在这些初步结果中，抑郁状态并未影响 HCV 感染患者这一小部分选择人群中的 SVR。在该人群中需要更大的样本量以获得足够的效力。
