焦虑和抑郁症状在急性丙型肝炎患者中很常见，且与疾病严重程度无关。

Symptoms of anxiety and depression are frequent in patients with acute hepatitis C and are not associated with disease severity.

作者信息

Deterding Katja, Grüner Norbert, Buggisch Peter, Galle Peter R, Spengler Ulrich, Hinrichsen Holger, Berg Thomas, Potthoff Andrej, Grohennig Anika, Koch Armin, Diepolder Helmut, Lüth Stefan, Feyerabend Sandra, Jung Maria C, Rogalska-Taranta Magdalena, Schlaphoff Verena, Cornberg Markus, Manns Michael P, Wedemeyer Heiner, Wiegand Johannes

机构信息

aHep-Net: German Network of Competence on Viral Hepatitis bDepartment of Gastroenterology, Hepatology and Endocrinology cDepartment of Biometry dDiagnostic Laboratory, Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover eMedical Department II, Institute for Immunology, Ludwig Maximilians University, Munich fDepartment of Internal Medicine, Division of Gastroenterology and Rheumatology, University of Leipzig, Leipzig gI. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg hI. Department of Internal Medicine, University Medical Center, Mainz iDepartment of Internal Medicine I, University of Bonn, Bonn jDepartment of Medicine, Christian Albrechts University, Kiel kDepartment of Hepatology and Gastroenterology, Charité University Hospital Berlin, Berlin, Germany.

出版信息

Eur J Gastroenterol Hepatol. 2016 Feb;28(2):187-92. doi: 10.1097/MEG.0000000000000517.

DOI:10.1097/MEG.0000000000000517

PMID:26575158

Abstract

OBJECTIVE

Neuropsychiatric symptoms of hepatitis C virus (HCV) infection and during peginterferon α therapy have been investigated in the chronic stage of the infection, but have not been described during the acute phase of the disease so far. We therefore evaluated anxiety and depression in patients with acute hepatitis C by the Hospital Anxiety and Depression Scale (HADS) within a clinical trial.

METHODS

Data were analysed from the German Hep-Net Acute HCV-III study. Anxiety and depression were characterized by an anxiety (HADS-A) and a depression subscale (HADS-D). More than eight points in each subscale were considered clinically relevant. Data were prospectively collected at baseline, end of treatment and at the end of the study.

RESULTS

At baseline, a HADS-A above eight points was observed significantly more frequently than a HADS-D above eight points [n=23/103 (22%) vs. n=12/103 (12%); P=0.041].A pathological HADS-A or HADS-D score did not correlate with age, sex, IL28B genotype, the probable mode of infection, HCV genotype or severity of disease as investigated by alanine aminotransferase and bilirubin levels.Antiviral therapy did not influence anxiety as 12/50 (24%) of patients had HADS-A above 8 at the end of therapy. The proportion of patients with HADS-D above eight points increased from 12% at baseline to 24% (n=12/50) at the end of therapy (P=0.06). HADS results were not associated with lost to follow-up or sustained virological response rates.

CONCLUSION

HADS data in acute HCV infection indicate that anxiety and depression do not correlate with severity of the disease, mode of acquisition, lost to follow-up and sustained virological response rates.

摘要

目的

丙型肝炎病毒（HCV）感染及聚乙二醇干扰素α治疗期间的神经精神症状已在感染的慢性期进行了研究，但迄今为止在疾病急性期尚未见报道。因此，我们在一项临床试验中，采用医院焦虑抑郁量表（HADS）对急性丙型肝炎患者的焦虑和抑郁情况进行了评估。

方法

分析德国肝病网络急性HCV-III研究的数据。焦虑和抑郁分别用焦虑分量表（HADS-A）和抑郁分量表（HADS-D）进行评估。每个分量表得分超过8分被认为具有临床意义。数据在基线、治疗结束时和研究结束时前瞻性收集。

结果

在基线时，HADS-A得分高于8分的情况显著多于HADS-D得分高于8分的情况[n=23/103（22%）对n=12/103（12%）；P=0.041]。经丙氨酸转氨酶和胆红素水平评估，HADS-A或HADS-D病理评分与年龄、性别、IL28B基因型、可能的感染方式、HCV基因型或疾病严重程度无关。抗病毒治疗对焦虑无影响，因为12/50（24%）的患者在治疗结束时HADS-A高于8分。HADS-D得分高于8分的患者比例从基线时的12%增加到治疗结束时的24%（n=12/50）（P=0.06）。HADS结果与失访或持续病毒学应答率无关。