Influence of the type of pegylated interferon on the onset of depressive and neuropsychiatric symptoms in HIV-HCV coinfected patients

Abstract

This is a prospective observational comparative 48-week study to assess the impact of the different types of Peg-IFN on depressive and neuropsychiatric symptoms during treatment in HIV-HCV coinfected patients. Thirty-one patients treated with Peg-IFN α-2b 1.5µg/kg/w plus ribavirine (RBV) (Peg-IFN α-2b Group) and 32 patients receiving Peg-IFN α-2a 180µg/w plus RBV (Peg-IFN α-2a Group) were included. Depressive and neuropsychiatric symptoms, quality of life and adherence were assessed. Fifteen subjects (23%) discontinued therapy (p = 0.3, between groups). Overall, 37 patients presented mild to moderate depressive symptoms, 9 moderate to severe and 3 severe, without differences between groups. Patients in Peg-IFN α-2b reported higher fatigue and dizziness at weeks 12 (p < 0.05) and 24 (p < 0.05), and irritability and memory loss at week 24 (p < 0.05) with respect to Peg-IFN α-2a Group. At week 12, role functioning, general health perception, vitality, emotional role, mental health and the summary areas of physical health and mental health were lower in Peg-IFN α-2b Group (p < 0.05). The same was observed in physical functioning (p = 0.05) and role functioning, general health perception, emotional role and mental health (p < 0.001) at week 24. Three months after finishing treatment, no patient had depressive or neuropsychiatric symptoms, and quality of life improved. Antiretroviral adherence was low but adherence to anti-HCV therapy remained high in both groups. According to our data, Peg-IFN α-2a and Peg-IFN α-2b exert a similar impact on the overall rate of depressive symptoms, although patients treated with Peg-IFN α-2a experience less fatigue and fewer neuropsychiatric symptoms and a lower impairment in their physical and mental quality of life.

Acknowledgments

The authors thank the patient volunteers and the members of Lluita contra la Sida Foundation that collaborated with their comments in the development of this study.

Jose A. Muñoz-Moreno was supported by contract FIPSE:12355/02 from the Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol in collaboration with the Fundación para la Investigación y la Prevención del Sida en España (FIPSE). Daniel Fuster received a grant from the Fundació Institut d'Investigació en Ciències de la Salut Germans Trias I Pujol. The authors had complete control over data collection and analysis.