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Lower activities of serum peptidases predict higher depressive and anxiety levels following interferon-alpha-based immunotherapy in patients with hepatitis C


Michael Maes MD, PhD, Professor of Psychiatry, Maastricht University Centre of Health, Psychiatric Hospital Vijverdal, Location 1st Floor, Suite S108, PO BOX 88, NL-6200 AB Maastricht, The Netherlands


Objective:  There is evidence that in patients with chronic hepatitis C, immunotherapy with interferon-alpha (IFNα) may induce depression. A lowered activity of peptidases, such as prolylendopeptidase (PEP) and dipeptidyl peptidase IV (DPP IV), occurs in depression. This study examines whether lowered serum PEP or DPP IV activity before starting IFNα-based immunotherapy predicts the increase in depressive symptoms during immunotherapy.

Method:  Serum PEP and DPP IV activities are measured in patients with hepatitis C before and 2, 4 and 16 weeks after starting IFNα-based immunotherapy. The Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Anxiety Rating Scale (HAM-A) are completed.

Results:  Patients with lower baseline PEP or DPP IV had significantly higher MADRS and HAM-A scores both at baseline and during immunotherapy. Patients with lower baseline DPP IV had significantly higher increases in the MADRS following IFNα treatment.

Conclusion:  Lower baseline PEP and DPP IV predict higher depressive and anxiety ratings during IFNα-based immunotherapy.