Incidence and factors related to neuropsychiatry side effects of interferon alpha in hepatitis B and C infected patients in Cote D'Ivoire

Introduction: Interferon alpha 2a (IFN alpha-2a) used as a treatment is associated with various neuropsychiatrie disorders. An assessment of these disorders is not systematic in Cote d'Ivoire whereas it is essential to ensure optimal virological response. Objectives: The objectives of this study were to determine the incidence of neuropsychiatrie disorders and look for risk factors in patients with hepatitis B or C on IFN alpha-2a followed in Abidjan (Cote d'Ivoire). Method: We carried out a descriptive cross-sectional study with hepatitis B and/or C infected patients followed at the Teaching Hospital of Cocody-Abidjan. The Mini International Neuropsychiatrie Interview (MINI) was used. We looked for a depressive episode, a suicidal risk or a (hypo) manic episode. Each patient was submitted to all questions of the MINI in a private area either at the pharmacy (during the dispensation of interferon) or in the Gastroenterology Department after medical consultation or at home after a calling appointment. Results: We recruited 64 patients. They had a median age of 39.5 years with a sex ratio of 1.78 males per female. They were suffering from hepatitis B (53.1%), C (45.3%) and B + C (1.6%); and were on pegylated IFN alpha-2a with less than 24 weekly injections performed in 56.3%. Ribavirin was most associated with interferon (50%). A major depressive episode (MDE) was diagnosed in 17.2% of our patients. A current suicidal risk (CSR) was diagnosed in 3.1% of patients. That is a total of 20.3% of patients who experienced neuropsychiatrie disorders. No hypo (manic) episode was diagnosed. The MDE was current in 7.8%o and past in 3.1% of these patients. Six point two percent of patients had both past and current MDE episodes. The CSR was of light kind. In our study, no therapeutic or biological factor significantly influenced the occurrence of MDE and CSR. Gender (p = 0.04) and BMI (p = 0.001) were significantly related to the occurrence of MDE whereas no demographic factor significantly influenced the occurrence of CSR. The type of hepatitis (C, B or B + C) was not significantly related to the occurrence of MDE (p = 0.1) or CSR (p >0.9). Conclusion: The incidence of neuropsychiatrie disorders was relatively important on IFN alpha-2a in Cote d'Ivoire. We recommend an assessment and a psychiatric management of patients before, during and after treatment with IFN alpha-2a