Interferon, part of the standard treatment for hepatitis C, is a major cause of depression in patients with the disease.
A new study has linked the high rate of suicide among hepatitis C patients to side-effects of interferon, which is usually taken together with ribavarin.
These findings will increase clinicians’ interest in alternatives to interferon in the treatment of the life-threatening infectious disease.
Researchers at Loyola University, Chicago, observed: “Depression is a relatively frequent and potentially serious complication of interferon therapy for hepatitis C virus infection.”
Hepatitis C is an increasingly widespread infection worldwide, causing pain, fatigue, disability and death.
The standard treatment is a combination of ribavirin and pegylated interferon. The latter can relieve muscle and joint pain and reduce fatigue.
However, interferon affects serotonin levels and is consequently associated with depression. The study reports that between 10% and 40% of hepatitis C patients receiving interferon experience depression and may be at risk of suicide.
The study authors recommend that patients with a personal or family history of depression or suicide attempts should be carefully assessed and possibly treated for that condition before treatment with interferon begins.
There is conflicting evidence about the effectiveness of antidepressants in patients who are receiving interferon – they may help to reduce the symptoms, but do not seem reliably able to prevent the condition.
Interferon also has flu-like symptoms, and the new study will increase the pressure to develop alternative treatments such as the combination therapy involving drugs from Gilead and BMS that recently demonstrated strong clinical efficacy in a phase II trial.