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Approximately 4.1 million Americans have been infected with hepatitis C, of who 3.2 million are chonically infected.
Currently, the best treatment for this disease is 6-12 months
of therapy with two antiviral drugs called interferon and
ribavirin. This combination can help the body's immune
system clear the hepatitis C virus (HCV), which it usually
can't do on its own.
Unfortunately, interferon has many serious side
effects. Some are physical, like fatigue and hair
loss,while others are neuropsychiatric, including depression,
irritability and cognitive impairment. Among hepatitis C
patients treated with interferon, the prevalence of
interferon-induced depressive symptoms has been reported to be
up to 44%. In addition, many people with previous mental
health problems or substance abuse problems are denied
treatment with interferon because of its difficult side
effects. Doctors are only just beginning to understand
how best to treat these side effects.
The Mood Disorders Center is currently working on three
clinical research projects related to interferon-induced
depression resulting from treatment for hepatitis C.
The Prophylactic Antidepressant Treatment (PAS) and
HepDep II study both examine depression and quality of life
in patients receiving interferon therapy for hepatitis C.
These studies are interested in managing the side-effects that
can occur with interferon therapy.
In addition, the Evaluation of Best Practices study reviews
the records of veterans with hepatitis C who elect to join a
confidential patient registry. By studying the records
of patients who receive standard clinical care for hepatitis
C, we can evaluate and improve how the Portland VA
Medical Center serves patients infected with hepatitis
C. Through the records of those who elect interferon
therapy, we can learn more about the effects of antiviral
treatment for hepatitis C and the best way to combat its
unwanted side effects. The project also aims to evaluate
the effectiveness of interferon treatment in special patient
populations previously viewed as poor candidates, such as
those who suffer from co-morbid psychiatric and substance
abuse conditions.
Ultimately, we hope all of these studies will facilitate
more effective hepatitis C treatment that is available to a
larger number of patients.
Our basic science laboratory conducts innovative research related to mood disorders, neuroscience, and immunology. Specific areas of interest are as follows:
- Investigating the relationship among interferon-induced neuropsychiatric side effects and associated changes in thyroid function, neurotransmitter systems, stress hormones, and other cytokines.
- The use of antidepressant and other novel pharmacotherapies for the treatment or prevention of inferferon-induced depression and sickness behavior.
- Identifying neurochemical and peripheral markers for interferon-induced depression and sickness behavior, focusing on tryptophan metabolic pathways.
- The laboratory is fully equipped for behavioral, molecular, and biochemical assays, including forced swim testing, locomotor activity monitoring, polymerase chain reaction, high performance liquid chromatograpy, immunoblotting and immunohistochemistry techniques.
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To conduct research in interferon-induced depression
and hepatitis C, the Mood Disorders Center is assisted by the
NW Hepatitis C Resource Center (NWHCRC). The NWHCRC is a
clinical collaboration of the Portland and Seattle VA medical
centers. It has been chosen as one of four VA sites
around the country charged with improving the treatment for veterans with hepatitis C.
The NW HCRC carries out a variety of services to assist
with and improve the care of veterans with hepatitis C. These
include:
For more information about the work of the NWHCRC, please
contact the Portland site at (503) 273-5264 or nwhcrc@med.va.gov.
Below are links to websites where you can learn more about
the VA's HCRC program, hepatitis C, and treatment for
hepatitis C.
VA
National HCRC home page - Informational pamphlets and
resources, both general and specific to veterans.
NW HCRC - More information on the NW
HCRC.
Centers
for Disease Control & Prevention - Hepatitis C - The
CDC's website on Hep C. Includes a fact sheet and FAQ
for patients and training info for physicians and nurses.
Hepatitis Information
Network - Comprehensive guide to all forms of hepatitis,
with resources for patients, articles, medical sites and new
developments.
Hepatitis C Outreach Project Mentoring - After a diagnosis of
Hepatitis C, you, your family or friends may feel fearful,
confused, overwhelmed and/or alone.
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