Hepatitis C infection is associated with depressive symptoms in HIV-infected adults with alcohol problems

Am J Gastroenterol. 2006 Aug;101(8):1804-10. doi: 10.1111/j.1572-0241.2006.00616.x. Epub 2006 Jun 16.

Abstract

Objectives: Depression is common in persons with HIV infection and with alcohol problems, and it has important prognostic implications. Neurocognitive dysfunction has been reported with chronic hepatitis C virus (HCV) infection. We hypothesized that HCV infection is associated with more depressive symptoms in HIV-infected persons with a history of alcohol problems.

Methods: We performed a cross-sectional analysis of baseline data from a prospective cohort study of 391 HIV-infected subjects with a history of alcohol problems, of whom 59% were HCV antibody (Ab) positive and 49% were HCV RNA-positive. We assessed depressive symptoms (Center for Epidemiologic Studies Depression [CES-D]) and past month alcohol consumption. In the primary analysis, we evaluated whether there were more depressive symptoms in HCV Ab-positive and RNA-positive subjects in unadjusted analyses and adjusting for alcohol consumption, gender, age, race, CD4 count, homelessness, drug dependence, and medical comorbidity.

Results: Mean CES-D scores were higher in subjects who were HCV Ab-positive compared with those who were HCV Ab-negative (24.3 vs 19.0; p < 0.001). In adjusted analyses, the difference in CES-D scores between HCV Ab-positive and Ab-negative subjects persisted (24.0 vs 19.0; p < 0.001). Unadjusted mean CES-D scores were also significantly higher in HCV RNA-positive subjects compared with those who were RNA-negative, and the difference remained significant (24.6 vs 19.3; p < 0.001) in adjusted analyses.

Conclusions: HCV/HIV coinfected persons with a history of alcohol problems have more depressive symptoms than those without HCV, and this association is unexplained by a variety of population characteristics. These data suggest that HCV may have a direct effect on neuropsychiatric function.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Alcoholism / complications
  • Alcoholism / psychology*
  • Blotting, Western
  • CD4 Lymphocyte Count
  • Chi-Square Distribution
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / complications
  • Depression / epidemiology
  • Depression / psychology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HIV Infections / complications
  • HIV Infections / psychology*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / psychology*
  • Homeless Persons
  • Humans
  • Linear Models
  • Male
  • Massachusetts / epidemiology
  • Middle Aged
  • Prognosis
  • Risk Assessment
  • Sex Factors