Liver Center, Cathay General Hospital Medical Center, Taipei, Taiwan.
It remains unclear whether depression in chronic hepatitis B and chronic hepatitis C during pegylated interferon-based therapy is associated with the virus, drug, or ethnic background. We aimed to perform a prospective study to evaluate the clinical course of depression and its predictors in consecutive non-cirrhotic chronic hepatitis B and C patients of same ethnicity receiving pegylated interferon-based therapy.
The occurrence and severity of depression were actively assessed by the Hamilton Depression Rating Scale before therapy and at week 2, 4, 6, 8, 10, 12, and every 4 weeks during treatment until the end of therapy. Extensive amount of variables (repeated measurements, time variables, and interactions between all variables) were included in Generalized Estimating Equations to analyze the predictors of depression.
A total of 158 consecutive patients (73 chronic hepatitis B and 85 chronic hepatitis C patients) were enrolled. Depression (Hamilton Depression Rating Scale ≥ 11) occurred in a biphasic pattern, at treatment week 2 to 10 and week 16 to 36. Treatment week < 10 predicts more depression and treatment week > 12 predicts less depression, suggesting the predictability of time variable during treatment on depression. Furthermore, chronic hepatitis C or pre-existing depression is independent predictor of depression in these patients (p<0.001).
Depression occurred in a biphasic pattern during pegylated interferon-based therapy and should be early and actively assessed especially in patients with chronic hepatitis C or pre-existing depression.