Does depression symptomatology affect medication compliance during the first weeks of anti-HCV therapy in intravenous drug users?

Abstract

Background Psychological adverse effects in intravenous drug users represent a challenge in the management of anti-HCV therapy. Aims To evaluate the depressive symptoms during the first weeks of anti-HCV therapy and to assess their impact on the early virological response and discontinuation of therapy. Subjects A prospective cohort study of HCV-infected drug addicts on a detoxification program at the onset of therapy with peg-interferon and ribavirin. Methods A self-report screening of depression (Center for Epidemiological Studies—Depression Scale) and a questionnaire investigating treatment adherence and the presence of side effects were prospectively administered. Results The mean baseline Center for Epidemiological Studies—Depression Scale score of the 43 subjects studied was 17.3. This value did not worsen significantly after 4 and 12 weeks of therapy. A higher depressive score at baseline neither significantly affected the early virological response, nor the early treatment discontinuation. Conversely, a higher symptoms score (HR 1.33; 95% CI, 1.02–1.71) was associated with a greater probability of early treatment discontinuation. Conclusions A depressive attitude should not be considered a contraindication to the treatment of HCV-infected drug addicts on the detoxification program in which they are monitored by a multidisciplinary team. Effective management of side effects could increase the treatment adherence during the first weeks of therapy and increase the possibility of an early virological response.