Reducing Depressive Symptoms During HCV Therapy: A Randomized Study

Inclusion Criteria: * Eligibility and interest in treatment for chronic HCV (Hepatitis C). * Absence of co-infection of HIV or Hepatitis B. * Age 25-68 years old. * No treatment with IFN (interferon-alpha) in the past 6 months. * Residence within a 3-hour drive of the clinic. Exclusion Criteria: * Patients must be willing to undergo treatment with PEG-interferon and ribavirin. They must be aware of the side effects of treatment and be motivated to self-administer the medications and come to regularly scheduled appointments. * Patients with diabetes mellitus must have good glycemic control. Their Hgb A1 c must be \<8.0%. * Patients must not have an active malignancy. * If patients have a history of severe psychiatric illness or are found to have one by screening with the CES-D, a psychiatrist must approve treatment. If the psychiatric problem is minor, it can be managed by the primary care physician or hepatitis C provider. * Autoimmune disease, such as autoimmune hepatitis, systemic lupus erythematosis, or sarcoidosis, is a contraindication to treatment. * Active alcohol or intravenous drug use is a contraindication to treatment. * Patients with a seizure disorder muct be seizure-free for 6 months prior to treatment. * Patients with a known history of coronary heart disease are excluded. * Patients with complications of cirrhosis may not be treatment candidates. Those who have a platelet count of \<50,000, large esophageal varices (grade 3-4), uncontrolled ascites, or uncontrolled encephalopathy are excluded. * Patients with severe mental retardation or dementia are excluded because of difficulty in self-administration of medication and in tolerating the side effects. * The patient and partner much agree to observe strict contraception to avoid pregnancy, since the medication is fetotoxic up to 6 months after treatment completion.