Role of treatment for depressive symptoms in relieving the impact of fatigue in HIV-HCV co-infected patients: ANRS Co13 Hepavih, France, 2006-2008

Authors: Michel, L.; Villes, V.; Dabis, F.1; Spire, B.; Winnock, M.1; Loko, M.-A.1; Poizot-Martin, I.2; Valantin, M. A.; Bonnard, P.3; Salmon-Céron, D.; Carrieri, M. P.
Source: Journal of Viral Hepatitis, Volume 17, Number 9, September 2010 , pp. 650-660(11)
Publisher: Wiley-Blackwell

Abstract:

Summary.

Fatigue is a major component of quality of life (QOL) and is associated with depression in HIV-HCV co-infected individuals. We investigated whether treating depressive symptoms (DS) could mitigate the impact of fatigue on daily functioning in co-infected patients, even those at an advanced stage of disease. The analysis was conducted on enrolment data of 328 HIV-HCV co-infected patients recruited in the French nationwide ANRS CO 13 HEPAVIH cohort. Data collection was based on medical records and self-administered questionnaires which included items on socio-behavioural data, the fatigue impact scale (FIS) in three domains (cognitive, physical and social functioning), depressive symptoms (CES-D classification) and use of treatments for depressive symptoms (TDS). After multiple adjustment for gender and unemployment, CD4 cell count <200 per mm3 was associated with a negative impact of fatigue on the physical functioning dimension (P = 0.002). A higher number of symptoms causing discomfort significantly predicted a higher impact of fatigue on all three dimensions (P < 0.001). This was also true for patients with DS receiving TDS when compared with those with no DS but receiving TDS. A significant decreasing linear trend (P < 0.001) of the impact of fatigue was found across the categories `DS/TDS', `DS/no TDS', `no DS/TDS' and `no DS/no TDS'. Despite limitations related to the cross-sectional nature of this study, our results suggest that routine screening and treatment for DS can reduce the impact of fatigue on the daily functioning of HIV-HCV co-infected patients and relieve the burden of their dual infection.

Keywords: ART; depression; fatigue; hepatitis C; quality of life
Document Type: Research article
DOI: 10.1111/j.1365-2893.2009.01223.x
Affiliations: 1: INSERM U897, ISPED, Université Victor Segalen, Bordeaux, France 2: CHU Sainte Marguerite, Marseille, France 3: Hôpital Tenon, Paris, France

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