Abstract
In chronic hepatitis C (CHC) patients, interferon-based treatments showed toxicity, limited efficacy, and psychiatric manifestations. Direct-acting antiviral (DAA) agents appeared safer, though it remains unclear if they may exacerbate or foster mood symptoms in drug-naïve CHC patients. We evaluated 62 CHC patients’ mental status, before and 12 weeks after DAA therapy, by assessment scales and psychometric instruments. We subdivided patients into two groups, CHC patients with (Group A) or without (Group B) a current and/or past psychiatric history. After DAA treatment, Group A patients showed low anxiety and improved depression, no variation in self-report distress, but worse general health perceptions. No significant difference emerged from coping strategies. Depression and anxiety improved in Group B, and no change emerged from total self-reported distress, except for somatization. Moreover, Group B increased problem-focused strategies for suppression of competing activities, and decreased strategies of instrumental social support. Contrarily, Group B reduced significantly emotion-focused strategies, such as acceptance and mental disengagement, and improved vitality, physical and social role functioning. DAA therapy is safe and free of hepatological and psychiatric side effects in CHC patients, regardless of current and/or past psychiatric history. In particular, patients without a psychiatric history also remarkably improved their quality of life.
Highlights
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide, liable to progress to cirrhosis and hepatocellular carcinoma (HCC) [1]
The HCV course is characterized by medical manifestations, such as fatigue and weakness, and by several neurological and psychiatric symptoms, including cognitive dysfunctions, sleep disorders, depression, anxiety, and anger/hostility, with a negative impact on patients’ quality of life (QoL)
Our cohort of chronic hepatitis C (CHC) patients treated with direct-acting antiviral (DAA) agents achieved an Sustained virologic response 12 (SVR12) of 98.4%, a percentage similar to that reported in other studies [27,28]
Summary
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide, liable to progress to cirrhosis and hepatocellular carcinoma (HCC) [1]. HCV infection is frequently associated with extrahepatic manifestations, including neurological and psychiatric complications due to direct. Patients with HCV infection report a higher prevalence of psychiatric disorders, including substance abuse (36%) and mood disorders (28%), compared with the general population [4]. The introduction of direct-acting antiviral (DAA) agents to treat CHC has led to improved recovery rates (>90% in all genotypes), as well as to prevent disease progression and adverse effect profiles [11], even in CHC patients with previous psychiatric and substance abuse disorders [12]. HCV clearance may prevent liver disease progression and partially control extrahepatic manifestations (i.e., mixed cryoglobulinemia), though not abolish the risk of HCC development [13]
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