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

• Published in: Journal of viral hepatitis Vol. 17; no. 9; pp. 650 - 660
• Main Authors: Michel, L., Villes, V., Dabis, F., Spire, B., Winnock, M., Loko, M.-A., Poizot-Martin, I., Valantin, M. A., Bonnard, P., Salmon-Céron, D., Carrieri, M. P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-09-2010
• Subjects: Adult; Antidepressive Agents - therapeutic use; CD4 antigen; Cognitive ability; Data collections; Data processing; Depression; Depression - drug therapy; Fatigue; Fatigue - drug therapy; Female; France; Hepatitis; hepatitis C; Hepatitis C, Chronic - complications; HIV Infections - complications; Human immunodeficiency virus; Humans; Infection; Inventories; Male; medical records; Middle Aged; Quality of life; Surveys and Questionnaires; Treatment Outcome; France
• ISSN: 1352-0504; 1365-2893
• DOI: 10.1111/j.1365-2893.2009.01223.x

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.