聚乙二醇干扰素-α-2a 治疗对近期丙型肝炎病毒感染期间心理健康的影响。

Effect of pegylated interferon-α-2a treatment on mental health during recent hepatitis C virus infection.

机构信息

The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia.

出版信息

J Gastroenterol Hepatol. 2012 May;27(5):957-65. doi: 10.1111/j.1440-1746.2011.07035.x.

DOI:10.1111/j.1440-1746.2011.07035.x

PMID:22142332

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3331928/

Abstract

BACKGROUND AND AIM

Pegylated interferon (PEG-IFN) treatment for hepatitis C virus (HCV) infection has neuropsychiatric side effects. Data on the effect of HCV treatment on mental health among injecting drug users (IDUs) are limited. We assessed mental health during treatment of recently acquired HCV, within a predominantly IDU population.

METHODS

Participants with HCV received PEG-IFN-α-2a (180 µg/week) for 24 weeks; HCV/HIV received PEG-IFN with ribavirin. Depression was assessed using the Mini-International Neuropsychiatric Interview (MINI). Logistic regression was used to identify factors associated with depression at enrolment and during treatment. Also, the effect of depression prior to and during treatment on sustained virological response (SVR) was assessed.

RESULTS

Of 163 participants, 111 received treatment (HCV, n = 74; HCV/HIV, n = 37), with 76% ever reporting IDU. At enrolment, 16% had depression (n = 25). In adjusted analysis, depression at enrolment occurred less often in participants full-/part-time employed (adjusted odds ratio [AOR] 0.23; 95% confidence interval [CI]: 0.06, 0.82, P = 0.023) and more often in recent IDUs (AOR 3.04; 95% CI: 1.19, 7.72, P = 0.019). During treatment, 35% (n = 31) developed new-onset depression. In adjusted analysis, poorer social functioning (higher score) was associated with new-onset depression (score ≤ 9 vs score ≥ 17; OR 5.69; 95% CI: 1.61, 20.14, P = 0.007). SVR was similar among participants with and without depression at enrolment (60% vs 61%, P = 0.951) and in those with and without new-onset depression (74% vs 63%, P = 0.293).

CONCLUSIONS

Although depression at enrolment and during treatment was common among participants with recent HCV, neither influenced SVR. Participants with poor social functioning may be most at risk of developing depression during HCV therapy.

摘要

背景和目的

聚乙二醇干扰素（PEG-IFN）治疗丙型肝炎病毒（HCV）感染有神经精神副作用。在注射吸毒者（IDU）中，关于 HCV 治疗对心理健康影响的数据有限。我们评估了在 IDU 人群中，最近感染 HCV 期间治疗期间的心理健康状况。

方法

HCV 患者接受 PEG-IFN-α-2a（180 µg/周）治疗 24 周；HCV/HIV 患者接受 PEG-IFN 联合利巴韦林治疗。使用迷你国际神经精神访谈（MINI）评估抑郁。使用逻辑回归确定与入组时和治疗期间抑郁相关的因素。此外，还评估了治疗前和治疗期间抑郁对持续病毒学应答（SVR）的影响。

结果

在 163 名参与者中，有 111 名接受了治疗（HCV，n=74；HCV/HIV，n=37），其中 76%曾报告有 IDU。入组时，16%的人患有抑郁症（n=25）。在调整分析中，在职/兼职参与者中抑郁的发生率较低（调整后的优势比 [AOR] 0.23；95%置信区间 [CI]：0.06，0.82，P=0.023），而近期 IDU 中抑郁的发生率较高（AOR 3.04；95%CI：1.19，7.72，P=0.019）。在治疗期间，有 35%（n=31）出现新发病例抑郁。在调整分析中，社会功能较差（得分较高）与新发抑郁症相关（得分≤9 与得分≥17；OR 5.69；95%CI：1.61，20.14，P=0.007）。在入组时患有和不患有抑郁症的参与者中，SVR 相似（60%与 61%，P=0.951），在出现和未出现新发抑郁症的参与者中，SVR 相似（74%与 63%，P=0.293）。