Co-occurring Depression, Chronic Pain and Substance Use Disorders in People with Hepatitis C

Abstract

Chronic infection with Hepatitis C virus (HCV) is common and can result in serious and sometimes fatal liver complications. The impact of HCV on the liver can be further complicated by medical and psychological comorbidities. Depression, substance use, and pain syndromes are frequent co-morbid conditions in people with HCV and diminish functioning, quality of life, and treatment compliance. Understanding the underlying biological mechanisms of these comorbid conditions within the context of HCV may help elucidate factors contributing to their co-occurrence, perhaps mediated via pro-inflammatory cytokines. The current review provides a synthesis of the literature on depression, substance use disorders and chronic pain in the presence of HCV. The review includes studies conducted with both veteran and civilian populations. The implications for assessment and antiviral treatment of HCV will be considered.

Integrating Screening and Treatment of Unhealthy Alcohol Use and Depression with Screening and Treatment of Anxiety, Pain, and Other Substance Use Among People with HIV and Other High-Risk Persons

“…Depression, chronic pain, and substance use are also linked to barriers to viral suppression and optimal clinical outcomes [36,[40][41][42][43][44]. Similarly, co-occurring depression, chronic pain, and substance use, may be more likely among individuals with HCV as compared with individuals without HCV [45][46][47][48][49][50].…”

Impact of Cigarette Smoking Status on Pain Intensity Among Veterans With and Without Hepatitis C

“…Multiple studies of veterans with HCV have indicated that pain intensity is less associated with biological disease indicators and more associated with psychological processes such as depression or pain catastrophizing [12]. Although there is a growing body of research characterizing the overlap and interconnection between HCV, pain, and mental health symptoms [5,13], far less attention has been paid to how smoking and HCV may interact to increase risk for pain.…”