https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.1840360730

Side effects of therapy of hepatitis C and their management.

[Non-A, non-B viral hepatitis].

The phenomenology and treatment of interferon-induced depression.

https://www.journal-of-hepatology.eu/article/S0168-8278(09)00157-3/pdf

Hepatitis C virus genotype 1b as a risk factor for hepatocellular carcinoma development: A meta-analysis

https://courses.washington.edu/conj504/readings/alter_reading4.pdf

Changing Trends in Hepatitis C-related Mortality in the United States, 1995-2004

Objective To assess the influence of hepatitis C virus (HCV) genotypes on the clinical outcome of liver disease, we analysed 2307 patients. Results The most frequently represented genotypes were 1 b (40%) and 2 (28.1%). Patients with these genotypes had a median age higher than patients with other genotypes (P < 0.01). The overall survival of subjects with genotype 1 b was poorer than the survival of patients with other genotypes (P< 0.01). Liver cirrhosis was found in 280 patients (12.1%), and type 1 b was the most represented isolate among them (P < 0.01). Sixty-two patients (22%) developed hepatocellular carcinoma (HCC) during a follow-up of 1481.8 cumulative years (estimated crude incidence rate, 4.1 cases per 100 person-years for all cirrhotics; 5.9 cases for genotype 1 a; 4.5 cases for genotype 1 b; and 2.8 cases for genotypes non-1). Considering the whole population of 2307 patients, only genotype 1 b was associated significantly with both cirrhosis and the development of HCC. One hundred and nineteen cirrhotic patients underwent treatment with interferon in uncontrolled studies. Interferon therapy was associated with both better survival (P <0.01) and a lower cumulative hazard for HCC (P< 0.01). Conclusions Genotype 1 b was associated with a poorer prognosis, probably because it leads to cirrhosis and consequently to HCC development. However, our data did not confirm genotype 1 b as an independent risk factor for HCC in liver cirrhosis, which plays a major role in carcinogenesis. Interferon should be considered as a useful strategy in cirrhosis for improvement of survival and reduction of HCC risk.

Outcome of liver disease in a large cohort of histologically proven chronic hepatitis C: influence of HCV genotype.

Objectives At the doses used for the treatment of chronic viral hepatitis, interferon (IFN)-related side-effects are usually modest, even though in some cases they require the interruption of therapy. Neuropsychiatric disturbances that range from modest depression and irritability to forms of manic-depressive psychosis and attempted or successful suicides are among the most important side-effects. The aim of our study was to determine whether the Minnesota Multiphasic Personality Inventory (MMPI) is a sensitive and reliable test for the early identification of patients at risk of depression before IFN therapy is commenced, and whether it could be useful for the monitoring of these patients during treatment. Methods We prospectively studied 67 patients with chronic active liver diseases, consecutively enrolled in open studies and treated with r-IFNα2. Before starting therapy and after 3 months of treatment, all patients underwent a clinical neurological evaluation and MMPI. Results At baseline, the correlation between the clinical evaluation and the score of the depression scale of the MMPI was statistically significant (P< 0.0001). Nine of 14 (64.3%) patients with a baseline score ≥ 60/100 showed a depressive mood after 3 months of therapy. Five of 44 patients (11.3%) with a baseline score < 60/100 showed a depression of medium level after 3 months of treatment This difference was highly significant (P< 0.0001). Conclusions According to our results, the MMPI is a reliable and sensitive test for the early identification of patients at risk of depression before and during IFN therapy for chronic viral liver diseases.

Nerina Mascoli

Papers

Outcome of liver disease in a large cohort of histologically proven chronic hepatitis C: influence of HCV genotype.

Depression during interferon therapy for chronic viral hepatitis: early identification of patients at risk by means of a computerized test.