Thursday, November 29, 2012

Study results indicate potential link between chronic HCV, depression

Study results indicate potential link between chronic HCV, depression

  • November 29, 2012
BOSTON — Patients with chronic hepatitis C may be at greater risk for depression, according to data presented at The Liver Meeting 2012.

Researchers assessed data on 15,263 adult patients collected from the National Health and Nutrition Examination Survey between 2005 and 2010. All participants had chronic hepatitis C or chronic hepatitis B; alcohol-related liver disease (ALD), defined as elevated aminotransferases and daily alcohol consumption of more than 20 g; or nonalcoholic fatty liver disease (NAFLD), defined as elevated aminotransferases without the presence of excessive alcohol consumption or other liver diseases. Depression was evaluated according to patient responses to the PHQ-9 survey.

“There have been some small studies in the past that have shown some association of depression with chronic hepatitis C, fatty liver disease and alcoholic liver disease,” Heshaam M. Mir, MD, research manager in the Liver & Obesity program at Inova Fairfax Hospital in Falls Church, Va., told “We wanted to see if those results translated to population-based studies.”

Multivariate analysis indicated that chronic HCV was independently associated with depression (OR=2.87; 95% CI, 1.78-4.62), in addition to other factors, including injection drug use (OR=52.86; 95% CI, 32.87-85.03), smoking (OR=6.20; 95% CI, 1.62-23.68) and black race (OR=2.50; 95% CI, 1.50-4.18). No association was observed between depression and chronic HBV, ALD or NAFLD.
Factors associated with NAFLD included diabetes (OR=1.54; 95% CI, 1.11-2.13) and insulin resistance (OR=2.65; 95% CI, 1.98-3.55), while ALD was associated with moderate-to-heavy smoking (OR=3.64; 95% CI, 3.09-4.30) and Mexican-American ethnicity (OR=1.55; 95% CI, 1.30-1.84). Researchers also observed associations between chronic HBV and black (OR=5.09; 95% CI, 2.41-10.76) or Hispanic race (OR=4.74; 95% CI, 2.32-9.70).

“Based on the results we found, the only association [with depression] is with chronic HCV,” Mir said, noting that this cross-sectional study allowed for the attribution of associations, but not causality. “We know that the current interferon-based regimens for HCV are known to have serious side effects, including psychiatric effects. If a patient is coming in with certain disorders, like depression, it’s important to keep that in mind before starting them on an interferon-based regimen.”

Disclosure: Researcher Zobair M. Younossi has served as a consultant for Salix and has served on advisory committees and/or review panels for Vertex and Tibotec.

For more information:
Otgonsuren M. P953: Association of Chronic Liver Disease with Depression: A Population-Based Study. Presented at: The Liver Meeting 2012; Nov. 9-13, Boston.

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