Biological mechanisms of depression following treatment with interferon for chronic hepatitis C: A critical systematic review.
Level 1 - systematic review of randomized trials
Systematic review of prospective cohort studies
PubMed 27936453 · doi:10.1016/j.jad.2016.11.039
What was done
Major electronic databases were searched up to February 15, 2016, for peer-reviewed prospective studies investigating biological mechanisms of major depressive episode (MDE) onset in chronic hepatitis C virus (HCV) patients treated with interferon-alpha (IFN-α). Included studies required MDE diagnosis via standardized diagnostic interviews at baseline and endpoint.
What was found
Eight prospective studies with 826 HCV patients (37.3% females, mean age 46.7 years, follow-up 4 to 48 weeks) met inclusion criteria. The overall MDE incidence rate was 34.8%. Variations in interleukin-6, salivary cortisol, arachidonic acid to eicosapentaenoic acid plus docosahexaenoic acid ratio, and genetic polymorphisms were linked to depressive predisposition across individual studies. Quantitative meta-analysis was not feasible due to heterogeneous mechanisms and lack of replication.
Why it matters
This review highlights candidate inflammatory, endocrine, and lipid pathways in interferon-induced depression while confirming that empirical biological evidence in humans remains fragmented and unreplicated.
Limits
Only eight studies met inclusion criteria, and methodological quality varied. Different studies examined distinct biomarkers, preventing quantitative meta-analysis and replication across independent cohorts. Abstract provides no specific numerical effect sizes for biomarker associations.
Cited by
- supports A very significant proportion of patients repeatedly administered interferon alpha for hepatitis C become clinically depressed.