Module Abstract

Answering the Questions: Depression Related to HCV and Its Treatment

Abstract

Chronic HCV infection in itself as well as interferon alfa–based therapy for the treatment of chronic hepatitis C are both often associated with psychiatric problems. More than 30% of patients chronically infected with HCV who have not yet received hepatitis C therapy suffer from neuropsychiatric abnormalities. The rate of depressive disorders characterized by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria ranges from approximately 6% to 10% in the general population vs 25% to 70% in patients infected with HCV. Neuropsychiatric adverse effects of interferon may be recognized in up to 75% of patients treated for chronic hepatitis C, with depression and anxiety among the most common effects. In addition to markedly reducing a patient’s quality of life during treatment, psychiatric adverse events may lead to interferon dose reduction and treatment discontinuation, followed by a reduction in the likelihood of sustained virologic response. Therefore, early detection and appropriate management of psychiatric adverse effects during treatment for chronic hepatitis C will facilitate adherence and virologic efficacy.

In this CME-certified module, Alfredo Alberti, MD; Lucia Gallego, MD; Michael R. Kraus, MD, PhD; and Vicente Soriano, MD, PhD, provide practical answers to frequently asked questions about diagnosing and managing depression before and during HCV treatment. Topics include:

• Epidemiology and Mechanisms
• Screening and Identification of Depression
• Prevention of Depression
• Antidepressant Use During HCV Therapy
• Other Strategies for Managing Depression During HCV Therapy
• Suicidal Ideation—Identification and Management
• Other Psychiatric Adverse Effects of Therapy