Assess Antiviral medication's effects on chronic hepatitis C patients' mental health

Abstract

Background: Chronic hepatitis C virus (HCV) infection is a global health issue associated with hepatic and extrahepatic complications, including psychiatric disorders that impair quality of life (QoL). Direct-acting antiviral agents (DAAs) have revolutionized HCV treatment, offering high cure rates and fewer side effects compared to interferon-based therapies. However, limited research explores the impact of DAA therapy on mental health and QoL. This study evaluates the mental health outcomes, psychiatric symptoms, coping mechanisms, and QoL in patients with HCV before and after DAA treatment.
Methods: A prospective observational study was conducted on 62 patients with chronic HCV infection, categorized into two groups: those with a current or past psychiatric history (Group A) and those without (Group B). Baseline and post-treatment assessments (12 weeks after DAA therapy completion) included psychiatric evaluations using the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and Symptom Checklist-90-Revised (SCL-90-R). Coping strategies were assessed using the Coping Orientation to Problems Experienced (COPE) Inventory, while QoL was measured with the Short Form-36 (SF-36) Health Survey. Statistical analyses examined within-group and between-group differences.
Results: At baseline, Group A exhibited higher levels of depression (HAM-D: 18.2 vs. 7.9; p < 0.01), anxiety (HAM-A: 21.5 vs. 10.3; p < 0.01), and psychological distress (SCL-90-R scores) than Group B. Following DAA therapy, both groups showed significant reductions in depression (Group A: 18.2 to 12.4, p < 0.05; Group B: 7.9 to 4.2, p < 0.01) and anxiety (Group A: 21.5 to 15.3, p < 0.05; Group B: 10.3 to 6.7, p < 0.01). Improvements in QoL were observed across most SF-36 dimensions, including mental health and vitality, with Group B experiencing more substantial gains. Coping strategies shifted toward active coping and problem-focused approaches post-treatment.
Conclusion: DAA therapy not only achieves virological cure but also significantly improves psychiatric symptoms, coping strategies, and QoL in patients with chronic HCV. Patients with a history of psychiatric disorders benefit from reduced psychological distress, though they continue to experience higher baseline symptomatology compared to those without such a history. These findings underscore the importance of integrating mental health assessments and support into HCV management to enhance overall patient outcomes.