Interferon-induced depression in chronic hepatitis C

Since the success rate of the antiviral treatment of chronic hepatitis C (HCV) is increasing, the knowledge of side effects due to this therapy must also improve. Among these side effects, depression and other neuro-psychiatric symptoms are among the most important. It must be outlined that conditions may exist before treatment in relation to the viral infection. However, pegylated interferon (IFN) administration is associated with a huge increase in the importance and the incidence of neuro-psychiatric symptoms. This has led several experts to claim that antiviral therapy should not be given to HCV patients having psychiatric contraindications. This last assertion seems to be disproved on the basis of results of recent clinical trials using selective serotonin reuptake inhibitors (SSRI). Pathogenesis of these neuro-psychiatric symptoms, however, remains unknown although the impact of IFN on glucocorticoid receptors and on serotonin 1A receptors is privileged. In conclusion, advances in HCV antiviral therapy and the comprehension and subsequent treatment of side effects induced by this therapy should allow us to treat more patients with greater success.