Depression in patients with chronic hepatitis-C treated with direct-acting antivirals: A real-world prospective observational study

Abstract

Background: Direct-acting antiviral (DAAs) therapy showed high safety and efficacy profile in patients with chronic hepatitis C (CHC) particularly those with previous or current psychiatric illness. The aim of this study was to evaluate the incidence and potential risk factors of depression and psychological distress following DAAs therapy in CHC euthymic Egyptian patients with no previous or current diagnosis of any psychiatric disorders.

Methods: This is a prospective study that included 126 patients diagnosed with chronic hepatitis C virus genotype-4. Patients were candidate for DAAs therapy and were recruited consecutively (convenient sample) from the viral hepatitis center, Department of Endemic medicine, Kasr Al-Ainy Hospitals, Cairo University. Symptom Checklist 90-R, Beck Depression Inventory (BDI) and Structured Clinical Interview for DSM-IV (SCID IV) were performed at baseline and at 12 weeks post-treatment with DAAs.

Results: Forty-seven patients were included in the final analysis. Depression severity increased after treatment as BDI scores increased significantly than baseline scores (p= < 0.001). About one third of patients (32%) had moderate to severe depression. All Symptom Checklist-90 scores showed significant increase after treatment.

Limitations: Dropout rate of patients for the 12 weeks post-treatment assessment was 33.8%.

Conclusion: Depression and psychological distress can occur with DAAs treatments. Close psychosocial assessment and patient monitoring are still needed.

Keywords: Chronic hepatitis C; Depression; Direct acting antiviral; Psychological distress.