Significant Decrease in the Prevalence of Anxiety and Depression after Hepatitis C Eradication

Abstract

Chronic hepatitis C (CHC) is an ongoing epidemiological problem. The hepatitis C virus (HCV) may infect brain tissue, worsening mental health outcomes. The new era of highly effective oral Direct-Acting Agents (DAA) has brought a chance to eradicate the infection by 2030, however, screening campaigns are urgently needed as the majority of the infected are still undiagnosed. The aim of this study was to assess the prevalence of anxiety and depression among HCV patients, and the correlation with health-related quality of life (HRQoL) in the real-world setting, before and after DAA treatment. Data on anxiety, depression, and HRQoL, were collected by using self-reported questionnaires in a single center in Poland. The study group involved 90 respondents, 50% female, with a mean age of 43.8 years. HCV eradication decreased anxiety prevalence from 30.4% to 19.1% and depression from 35.2% to 18.2%. Significant improvement in 3 out of 4 of the WHOQOL-BREF (TheWorld Health Organization Quality of Life-BREF) domains and 8 out of 10 of the HQLQv.2 domains was obtained. Anxiety diminished the somatic domain scores by 3.5 (p < 0.0001), psychological by 2.3 (p = 0.0062), social by 1.75 (p = 0.0008), and environmental by 2.68 points (p = 0.0029). Depression diminished the somatic domain scores by 3.79 (p < 0.001), psychological by 2.23 (p < 0.001), social by 1.84 (p < 0.001), and environmental by 2.42 points (p = 0.004). In the Hepatitis Quality of Life Questionnaire version 2 (HQLQ v.2), the presence of depression and/or anxiety-impaired mental health, physical health, well-being, and vitality. These results indicate the need for an active search for HCV-infective people, especially among patients in psychiatric and psychological care.

Keywords: GAD-7; HCV eradication; HQLQv.2; HRQoL; PHQ-9; WHOQOL-BREF; anxiety; depression; hepatitis C.

Figure 1

The results of anxiety classification according to the GAD-7 scale at baseline and at EOT. EOT—end of treatment.

Figure 2

The results of depression classification according to the PHQ-9 scale at baseline and at EOT. EOT—end of treatment; PHQ-9—Patient Health Questionnaire.

Figure 3

The scoring results of GAD-7 transformed to 0–100 scale at the baseline (light blue box) and at EOT (navy box) in the subgroups analysis. EOT—end of the treatment; GAD-7—Generalized Anxiety Disorder; F—female; M—male; * p < 0.05; ** p < 0.01; *** p < 0.001; NS—not significant.

Figure 4

The scoring results of PHQ-9 transformed to 0–100 scale at the baseline (light blue box) and at EOT (navy box) in the subgroups analysis. EOT—end of the treatment; PHQ-9—Patient Health Questionnaire; F—female; M—male; * p < 0.05; ** p < 0.01; *** p < 0.001.

Figure 5

Spearman’s Rank correlations for all of the domains in EOT. EOT—end of the treatment; HQLQ v.2—Hepatitis Quality of Life Questionnaire; F—Physical Functioning; R—Role Physical; P—Bodily Pain; H—General Health; V—Vitality; S—Social Functioning; E—Role Emotional; W—Wellbeing; PCS—Physical Component Score; MCS—Mental Component Score; GAD7—Generalized Anxiety Disorder; PHQ9—Patient Health Questionnaire.