Infecções virais e depressão

Effects of Melatonin Alone or Associated with Acyclovir on the Suppressive Treatment of Recurrent Genital Herpes: A Prospective, Randomized, and Double-Blind Study

Suppressive therapy of recurrent genital herpes is a challenge, and melatonin may be an alternative. Objective: To evaluate the action of melatonin, acyclovir, or the association of melatonin with acyclovir as a suppressive treatment in women with recurrent genital herpes. Design: The study was prospective, double-blind, and randomized, including 56 patients as follows: (a) The melatonin group received 180 placebo capsules in the ‘day’ container and 180 melatonin 3 mg capsules in the ‘night’ container (n = 19); (b) The acyclovir group received 360 capsules of 400 mg acyclovir twice a day (one capsule during the day and another during the night) (n = 15); (c) the melatonin group received 180 placebo capsules in the ‘day’ container and 180 melatonin 3 mg capsules in the ‘night’ container (n = 22). The length of treatment was six months. The follow-up after treatment was six months. Patients were evaluated before, during, and after treatment through clinical visits, laboratory tests, and the application of four questionnaires (QSF-36, Beck, Epworth, VAS, and LANNS). Results: No statistically significant difference was observed for the depression and sleepiness questionnaires. However, in the Lanns scale for pain, all groups decreased the mean and median values in time (p = 0.001), without differentiation among the groups (p = 0.188). The recurrence rates of genital herpes within 60 days after treatment were 15.8%, 33.3%, and 36.4% in the melatonin, acyclovir, and association of melatonin with acyclovir groups, respectively. Conclusion: Our data suggest that melatonin may be an option for the suppressive treatment of recurrent genital herpes.

Symptoms of depression and quality of life of people living with HIV/AIDS

This is a cross-sectional study conducted with 228 people living with HIV/AIDS in a municipality in the State of São Paulo during 2007 and 2008. The aims of this study were to investigate the intensity of the depressive symptoms in individuals with HIV/AIDS treated at two referral units in Ribeirão Preto, Brazil, and to compare the quality of life with the different degrees of intensity of the depressive symptoms in these individuals, according to gender. Data were collected through individual interviews, using the Beck Depression Inventory and HIV/AIDS Targeted Quality of Life (HATQoL). A total of 63 (27.6%) patients with symptoms of depression (mild, moderate and severe) were detected. The women presented more severe symptoms of intensity of depression than men. Individuals with depressive symptoms presented lower scores of quality of life than individuals without these symptoms, with statistically significant differences between the means/medians in most domains of the HATQoL. Healthcare professionals should offer integral care for people with HIV/AIDS, emphasizing the depressive symptoms.

Higher rate of major depression among blood donor candidates infected with human t-cell lymphotropic virus type 1

OBJECTIVE

Viral infections have been previously associated with psychiatric disorders. This work aimed to study the relationship between the human T-cell lymphotropic virus type 1 (HTLV-1) and depression.

METHOD

A case-control study with prevalent cases was conducted from April 2004 to June 2005. Participants were from a public transfusion center in Belo Horizonte, Brazil. The base population was composed of blood donor candidates infected with HTLV-1 (asymptomatic carriers), followed-up in a cohort study. As a control group, HTLV-1 seronegative blood donors were selected in a random fashion. Study participants underwent psychiatric evaluation using a structured diagnostic instrument, the Mini International Neuropsychiatry Interview (MINI), to estimate the rate of depression. The interviewer was unaware of participants' HTLV-1 serostatus. The co-variables studied were gender, age, formal education, personal income, and the presence of other psychiatric diagnoses. Logistic regression was used to examine the relation between HTLV-1 infection and depression.

RESULTS

The final sample was composed of 74 individuals infected with HTLV-1 and 24 uninfected controls. The rate of depression was significantly higher in HTLV-1 carriers when compared with controls (39% vs. 8%; p-value = 0.005). HTLV-1 infection was independently associated with depression (OR = 6.17; CI 95% = 1.32-28.82).

CONCLUSIONS

The results showed a higher rate of depression in HTLV-1 infected individuals. It was not possible to determine whether depression was related to knowledge of chronic retroviral infection or related to a biological effect of the retroviral infection.