Neuropsychiatric effects and type of IFN-alpha in chronic hepatitis C

Chronic hepatitis is often associated with neuropsychiatric disorders. Inte rferon (IFN) is the drug most widely used to treat this disease, and its si de effects, such as depression, often involve the central nervous system (C NS). Symptoms include a slowing down of psychomotor functions, loss of inte rest, frontal lobe dysfunction, parkinsonism, and delirium. The occurrence of these complications calls for dropping out of IFN treatment or for a sig nificant dose reduction and administration of antidepressants. Efficacy and side effects vary on the basis of the IFN type employed. The aim of our st udy was to evaluate if the frequency, form, and degree of depression induce d are related to the type of IFN employed. We studied 96 patients with chro nic hepatitis C. Our study series was divided into four groups according to the type of IFN-alpha administered. Depression degree was clinically evalu ated using the Hamilton Depression Rating Scale (HAM-D). All patients were tested before treatment and 1, 3, and 6 months (15 days after the end of tr eatment) later. Our results showed that the type of IFN used seemed to infl uence the depression onset rate, with the leukocyte type inducing the lowes t level of depression. However, when a number of symptoms associated with t he depression were considered, the results of other types of IFN-alpha were found to be better. Use of the most suitable type of IFN-alpha could thus lead to more personalized treatment, with fewer side effects. The type of I FN used seems to influence the psychological side effects and the adaptatio n rate to therapy. It would be appropriate to choose the type of IFN on the basis of a neuropsychiatric assessment carried out before treatment.