Paroxetine for prevention of depressive symptoms induced by interferon-alpha and ribavirin for hepatitis C.

BACKGROUND: Whether antidepressants prevent depression during interferon-alpha/ribavirin treatment for hepatitis C virus infection has yet to be established. AIM: To investigate the use of paroxetine in a prospective, double-blind, placebo-controlled study for this indication. METHODS: Sixty-one hepatitis C virus-infected patients were randomly assigned to the antidepressant, paroxetine (n = 28), or placebo (n = 33), begun 2 weeks before and continued for 24 weeks during interferon-alpha/ribavirin treatment. Primary endpoints included development of major depression and severity of depressive symptoms measured by the Montgomery Asberg Depression Rating Scale (MADRS). RESULTS: Rates of major depression during the study were low (17%) and did not differ between groups. Nevertheless, using published MADRS cut-off scores, the percent of subjects who met criteria for mild, moderate or severe depression during interferon-alpha/ribavirin therapy was significantly lower in paroxetine- vs. placebo-treated subjects (P = 0.02, Fisher's exact test). Assignment to paroxetine was also associated with significantly reduced depressive symptom severity. This effect was largely accounted for by participants with depression scores above the median (MADRS > 3) at baseline in whom paroxetine was associated with a maximal reduction in MADRS scores of 10.3 (95% CI: 2.1-18.5) compared with placebo at 20 weeks (P < 0.01). Study limitations included a small sample size and high drop-out rate. CONCLUSION: This double-blind, placebo-controlled trial provides preliminary data in support of antidepressant pre-treatment in hepatitis C virus patients with elevated depressive symptoms at baseline.

[The efficacy of taktivin in patients with viral myocarditis and dilated cardiomyopathy]. / Effektivnost' taktivina u bol'nykh virusnym miokarditom i dilatatsionnoi kardiomiopatiei.

The aim of the present research was to study the efficacy of the immunomodulating agent T-activin in patients with viral myocarditis and dilated cardiomyopathy (DCMP). The data obtained indicate that under the influence of the general therapy with T-activin cellular immunity manifested positive changes and the patients with viral myocarditis and DCMP felt better.

[Immunological characteristics of viral myocarditis]. / Immunologicheskaia kharakteristika virusnogo miokardita.

A study of cellular and humoral immunity was conducted in patients with viral myocarditis. Quantitative and functional deficiency of T-suppressors and an increase in the number of cytotoxic lymphocytes were revealed in most patients. Disorder in the T-cellular link of immunity correlated with a clinical course of the disease and was found more frequently in patients with a grave course of myocarditis.

[Indices of the interferon system in patients with viral myocarditis and dilated cardiomyopathy]. / Pokazateli sistemy interferona u bol'nykh virusnym miokarditom i dilatatsionnoi kardiomiopatiei.

The authors presented some data on the investigation of the interferon system in patients with dilatation cardiomyopathy (DCM) and viral myocarditis (VM). Diagnosis was verified according to the WHO criteria. Altogether 10 DCM patients and 24 VM patients with a grave course were investigated. Antibodies to Coxsackie B virus and influenza were detected in the VM patients. A decrease in the alpha- and gamma-interferon activity was shown in all DCM patients. The VM patients with a grave course also demonstrated a decrease in the alpha- and especially gamma-interferon (immune) activity. Methods of immune correction in such patients were discussed.