Incidence of depression in patients with hepatitis C treated with direct-acting antivirals

Abstract

Objective: Depression has been associated with hepatitis C, as well as with its treatment with proinflammatory cytokines (i.e., interferon). The new direct-acting antiviral agents (DAAs) have minimal adverse effects and high potency, with a direct inhibitory effect on non-structural viral proteins. We studied the incidence and associated factors of depression in a real-life prospective cohort of chronic hepatitis C patients treated with the new DAAs. Methods: The sample was recruited from a cohort of 91 patients with hepatitis C, of both sexes, with advanced level of fibrosis and no HIV coinfection, consecutively enrolled during a 6-month period for DAA treatment; those euthymic at baseline (n=54) were selected. All were evaluated through the depression module of the Patient Health Questionnaire (PHQ-9-DSM-IV), at three time points: baseline, 4 weeks, and end-of-treatment. Results: The cumulative incidence (95%CI) of major depression and any depressive disorder during DAA treatment was 13% (6.4-24.4) and 46.3% (33.7-59.4), respectively. No differences were observed between those patients with and without cirrhosis or ribavirin treatment (p 4 0.05). Risk factors for incident major depression during DAA treatment included family depression (relative risk 9.1 [1.62-51.1]), substance use disorder (11.0 [1.7-73.5]), and baseline PHQ-9 score (2.1 [1.1-3.1]). Conclusions: The findings of this study highlight the importance of screening for new depression among patients receiving new DAAs, and identify potential associated risk factors.

Improvement of sexuality after hepatitis C cure with direct acting antivirals

“…16,17 Its treatment often leads to restoration of sexual functioning, although antidepressants may themselves also be associated to sexual disabilities. 17 At baseline, the prevalence of major depression in our cohort was in line with previous reports in HCV-patients 1,18 (20.4%). We have shown that assessment of depression is important when exploring sexuality: major depression (PHQ9 > 10) (but not the use of antidepressants) and age ≥ 55 years were independently associated with sexual dysfunction at baseline, with prevalence close to 90% in this subpopulation.…”

Effects of Direct-Acting Antiviral Agents on the Mental Health of Patients with Chronic Hepatitis C: A Prospective Observational Study

“…Yet, differences exist in the design, sample, and size of the study, clinical and time evaluation, severity and definition of psychopathological symptoms, plus the use of self-reported or observer-rated diagnostic interview scales [29][30][31][32][33][34]. According to a few studies [12,[35][36][37][38], DAA therapy is safe and does not worsen the depressive or other psychiatric symptoms in CHC patients with pre-existing mental diseases. Other studies, differently, feature the possible onset of mood symptoms in patients with psychiatric history [15][16][17].…”

Effects of Direct-Acting Antiviral Agents on the Mental Health of Patients with Chronic Hepatitis C: A Prospective Observational Study

“…Yet, differences exist in the design, sample, and size of the study, clinical and time evaluation, severity and definition of psychopathological symptoms, plus the use of self-reported or observer-rated diagnostic interview scales [29,[31][32][33][34]. According to a few studies [12,[35][36][37][38], DAA therapy is safe and does not worsen the depressive or other psychiatric symptoms in CHC patients with pre-existing mental diseases. Other studies, differently, feature the possible onset of mood symptoms in patients with psychiatric history [15][16][17].…”