Primary Endpoints

• Effect of an antidepressive pre-treatment over two weeks and a continuously concomitant treatment with Escitalopram on frequency and severity of depression in patients with chronic hepatitis C treated with Peg-interferon alfa 2a and ribavirin. The occurrence of moderate to severe depression is measured by the Hamilton Depression Rating Scale 24 weeks after starting interferon therapy.

Secondary Endpoints

• Quality of life (SF-36)
• Drop-out rate
• Biochemical response defined by serum GPT values 24 weeks after treatment Virological response measured by HCV-RNA at the end of treatment and after six month of treatment
• Predictive parameters for patients especially gaining from an antidepressive therapy (e.g. age, gender, weight, height, ALT quotient defined as median ALT values before treatment divided by the upper standard value, GGT, HCV-RNA serum concentration,
• level of fibrosis in liver histology, baseline values of the different psychometric scales*)
• Comparison of safety placebo versus verum (from psychiatric and hepatological view)

Inclusion Criteria:

• Chronic hepatitis C infection defined as positive anti-HCV antibodies and serum HCV-RNA >1000 IU/ml, naive to antiviral treatment
• Age >18 years
• all HCV genotypes
• Patients must be willing and able to adhere to dosing and visit schedules

Exclusion Criteria:

• Antidepressive treatment within the last 3 years
• psychiatric diseases in past medical history
• active substance abuse
• pregnancy, lactation, wish to become pregnant
• HBV/HIV-Coinfection
• decompensated liver disease, hepatocellular carcinoma, history of bleeding esophageal varices
• Neutropenia (1500/ul, thrombocytopenia (<70/nl), anemia (<12g/dl in females, <13g/dl in males)
• history of autoimmune disease
• history of organ transplantation, concomitant liver disease, severe cardiopulmonal disease, hemolytic anemia, malignant disease