Somatic pain associated with initiation of interferon-alpha (IFN-α) plus ribavirin (RBV) therapy in chronic HCV patients: A prospective study

Chih Ying Lin; Ta-Wei Guu; Hsueh-Chou Lai; Cheng-Yuan Peng; Jill Yi-Ju Chiang; Hui-Ting Chen; Tsai-Chung Li; Shing-Yu Yang; Kuan-Pin Su; Jane Pei-Chen Chang

doi:10.1016/j.bbih.2019.100035

Somatic pain associated with initiation of interferon-alpha (IFN-α) plus ribavirin (RBV) therapy in chronic HCV patients: A prospective study

Brain Behav Immun Health. 2020 Jan 3:2:100035. doi: 10.1016/j.bbih.2019.100035. eCollection 2020 Feb.

Authors

Chih Ying Lin^{1

2}, Ta-Wei Guu^{3

2}, Hsueh-Chou Lai^{1

4}, Cheng-Yuan Peng^{1

4}, Jill Yi-Ju Chiang², Hui-Ting Chen², Tsai-Chung Li^{1

5}, Shing-Yu Yang^{1

5}, Kuan-Pin Su^{1

6

2}, Jane Pei-Chen Chang^{1

6

2}

Affiliations

¹ School of Medicine, China Medical University (CMU), Taichung, Taiwan.
² Mind-Body Interface Lab (MBI-Lab) and Department of Psychiatry, CMUH, Taichung, Taiwan.
³ Department Psychiatry, CMU Beigang Hospital, Yunlin, Taiwan.
⁴ Departement of Hepatogastroenterology, China Medial University Hospital, Taichung, Taiwan.
⁵ China Medical University Graduate Institute of Biostatistics, Taiwan.
⁶ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Abstract

Objective: This study is aimed to investigate the association between interferon-alpha (IFN-α) plus ribavirin (RBV) treatment and emergence of somatic pain symptoms in patients with hepatitis C virus (HCV) over a 24-week treatment.

Method: In this prospective cohort study, 297 patients with HCV were evaluated at baseline and 2nd, 4th, 8th, 12th, 16th, 20th, and 24th week with structured Mini-International Neuropsychiatric Interview for Major Depressive Disorder (MDD) diagnosis and the Neurotoxicity Rating Scale (NRS) for somatic symptoms.

Results: Eighty-seven out of the 297 patients (29%) developed IFN-α induced depression and had significantly higher somatic pain symptoms as early as the 2nd week and at all the assessment time points (p < .001). Most depressed patients perceived greatest somatic pain at the 8th week of treatment. Moreover, NRS somatic pain scores after initial therapy strongly correlated with NRS somatic pain scores at all other assessment time points (p < .001).

Conclusion: IFN-α therapy induce significant somatic pain as early as the 2nd week of treatment in HCV patients who later developed MDD. Thus, initial NRS somatic pain score after initiation of IFN-α treatment may serve as a reference for the susceptibility of the individual to IFN-α induced depression.

Keywords: IFN-α; Major depressive disorder; Somatic pain.