Monitoring depression in patients undergoing alpha-interferon and ribavirin therapy for hepatitis C

Individuals with hepatitis C virus (HCV) constitute a growing segment of the US population, with most new infections attributable to intravenous drug use. Commonly, there is a 10- to 30-year delay from time of infection to diagnosis. Current treatment is with interferon, alone or in combination with ribavirin. A concerning side effect of both monotherapy and combination therapy is depression, which can become severe and lead to suicide. In patients with liver disease and those who have used intravenous drugs, depression is highest among those who are also positive for HCV. Use of a standardized short form depression self-rating tool would provide the advantages of increased accuracy in patient assessment, improved documentation, and cost-effective monitoring of depression in patients with HCV receiving interferon/ribavirin therapy. This article discusses the importance of screening and monitoring patients for depression as they undergo treatment for HCV infection with interferon alone or in combination therapy with ribavirin.