High prevalence of fatigue and depression in HIV/Hepatitis C co-infected patients treated with pegylated interferon/ribavirin

Psychiatric side effects of IFN are a frequent reason for discontinuation of treatment. We conducted a retrospective study of 70 patients co-infected with Hepatitis C and HIV enrolled in a treatment trial. 70% of the patients reported fatigue, 27% complained of depressed mood, and 19% had both. A total of 37% of all patients stopped IFN before the 1 year treatment protocol. Those who discontinued treatment were not more likely to be fatigued or depressed than those who did continue. There were no suicides or psychiatric hospitalizations during the study period. These results are preliminary but suggest that monitoring and treating both fatigue and depression can enhance adherence and improve quality of life. Treatment strategies using psycho stimulants (both amphetamine and non-amphetamine), testosterone, and anti-depressants to combat low mood are described.