Abstract

PSYCHIATRIC SYMPTOMS INDUCED BY ANTIVIRAL THERAPY IN HEPATITIS C INFECTION

Dr. Gurmeet Kaur Brar*, Dr. Ravinder Garg and Dr. Hargurpal Singh Brar

ABSTRACT

Despite recent advances in hepatitis C (HCV) treatment, especially the direct acting antiviral (DAAs), pegylated interferon (Peg IFN) alpha 2a &2b remains the backbone of HCV therapy. Objective: To evaluate the symptom profile of psychiatric co-morbidity in patients receiving Peg IFN-alpha and Ribavirin(Riba). Methods: 65 consecutive patients with HCV on combination of Peg IFN-α 2a/2b and Riba were assessed at baseline and thereafter at 2, 4, 8 and 12 weeks. At the baseline, patients were assessed on Patient Health Questionnaire (PHQ-9), Mini International Neuropsychiatric Interview (MINI) and Beck Depression Inventory (BDI-II) and thereafter on PHQ-9 and whenever found to have Major Depressive Disorder as per PHQ-9, they were assessed on MINI. Results: Peg IFN-alpha and Riba induced major depressive episodes (MDE) include sadness, irritability, work inhibition, sleep disturbance, fatigability and loss of appetite. Presence of certain symptoms like, less interest or pleasure in doing things, feeling tired or having little energy, poor appetite, social withdrawal and work inhibition at the baseline was associated with development of depression during the course of Peg IFN-alpha plus Riba therapy. Conclusion:- Depressive symptoms in patients with Peg IFN-alpha and Riba are influenced by the symptoms of depression prior to the initiation of treatment. Therefore, a short screening questionnaire needs to be applied at the baseline to predict the development of depression and screen patients at high risk for the development of depression.

Keywords: Despite recent advances in hepatitis IFN-alpha and Ribavirin(Riba).