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Depressive symptoms in chronic hepatitis C are associated with plasma apolipoprotein E deficiency

David A Sheridan1, S H Bridge, M M E Crossey

  • 1Institute of Cellular Medicine (Hepatology), Newcastle University, William Leech Building, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK, david.sheridan@ncl.ac.uk.

Metabolic Brain Disease
|March 12, 2014
PubMed

Insights

Hepatitis C patients often experience depression linked to low apolipoprotein E. Omega-3 fatty acids may help anxiety, but lipid-lowering drugs could worsen depression in these patients.

Area of Science:

  • Neuroscience
  • Hepatology
  • Psychiatry

Background:

  • Chronic hepatitis C (CHC) infection frequently co-occurs with neuro-psychiatric and cognitive disorders, impacting patient quality of life and treatment outcomes.
  • Hepatitis C virus (HCV) possesses neurotrophic properties and influences lipid metabolism, which is crucial for cognitive functions.

Purpose of the Study:

  • To investigate the association between lipid profiles and depression/anxiety symptoms in CHC patients.
  • To evaluate the efficacy of fluvastatin and omega-3 ethyl esters (n-3 PUFA) in managing these symptoms in CHC non-responders.

Main Methods:

  • A randomized pilot study involving 60 CHC patients who were prior non-responders.
  • Fasting lipid profiles and anxiety/depression symptoms (using HADS) were assessed over 12 weeks of treatment.
  • Participants received either fluvastatin or high-dose n-3 PUFA therapy.

Main Results:

  • Depression was significantly associated with lower apolipoprotein E concentrations (P=0.029) and a trend towards lower total cholesterol.
  • Three patients discontinued lipid-lowering treatment due to exacerbated depression.
  • A modest but significant improvement in anxiety symptoms was observed with high-dose n-3 PUFA therapy.

Conclusions:

  • Depression in CHC patients is linked to apolipoprotein E deficiency, potentially compromising blood-brain barrier integrity and promoting central nervous system (CNS) involvement.
  • High-dose n-3 PUFAs may offer benefits for anxiety symptoms in CHC patients.
  • Lipid-lowering therapy in CHC requires careful consideration of the risk of worsening depression.

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