Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 28;5(1):100614.
doi: 10.1016/j.jhepr.2022.100614. eCollection 2023 Jan.

Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH)

Fabienne Marcellin  1 , Sylvie Brégigeon-Ronot  2 , Clémence Ramier  1 , Camelia Protopopescu  1 , Camille Gilbert  3 , Vincent Di Beo  1 , Claudine Duvivier  4   5   6   7 , Morgane Bureau-Stoltmann  1 , Eric Rosenthal  1   8 , Linda Wittkop  3   9 , Dominique Salmon-Céron  10   11 , Patrizia Carrieri  1 , Philippe Sogni  11   12   13 , Tangui Barré  1 ; ANRS CO13 HEPAVIH Study Group; Scientific Committee; Clinical Centers (ward: participating physicians); Data collection; Management, statistical analyses
Collaborators, Affiliations

Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH)

Fabienne Marcellin et al. JHEP Rep. .

Abstract

Background & aims: A growing literature shows an improvement of chronic hepatitis C virus (HCV)-related depression after successful treatment with direct-acting antivirals. However, depression after HCV cure remains insufficiently documented in people living with HIV (PLWH) and HCV, a population with specific mental health challenges. This study aimed to (i) document the prevalence of moderate-to-severe depression (PHQ-9 score ≥10) across different age classes in HCV-cured PLWH; (ii) identify associated socio-behavioral correlates.

Methods: Descriptive analyses were performed on data collected during a cross-sectional survey (February 2018 - May 2019) nested in a prospective, multicenter cohort of individuals living with HIV and HCV (ANRS CO13 HEPAVIH). Socio-behavioral correlates of moderate-to-severe depression were identified using logistic regression.

Results: Among the 398 HCV-cured individuals in the study sample (median age [IQR]: 56 [53-59] years; 73.1% men), 23.9% presented with moderate-to-severe depression (PHQ-9 score ≥10). Depressive symptom prevalence rates were as follows: anhedonia: 52.3%; feeling 'down' or feelings of hopelessness: 48.3%; sleeping problems: 65.7%; lack of energy: 70.3%; eating disorders: 51.2%; lack of self-esteem: 34.3%; difficulty concentrating: 34.9%; sluggishness (in movement and voice) or restlessness: 24.6%; suicidal ideation: 17.1%. No significant difference was detected across age classes. Female sex, unhealthy alcohol use, sedentary lifestyle, and unhealthy eating behaviors were associated with increased odds of moderate-to-severe depression.

Conclusions: Depressive symptoms were common in this sample of HCV-cured PLWH. Unlike findings for the French general population, the prevalence of depression did not decrease with age class. Mental health remains a key issue for HIV-HCV-coinfected individuals, even after HCV cure, especially in women and in individuals with unhealthy behaviors.

Lay summary: Despite potential improvements in mental health after successful treatment with direct-acting antivirals, many people living with HIV (PLWH) and hepatitis C virus (HCV) - even in older age classes - still face depressive symptoms after HCV cure. In this population, women and people reporting unhealthy alcohol use, sedentary lifestyle, or unhealthy eating behaviors are more prone to report depressive symptoms after HCV cure. Mental health and lifestyle-related issues should be integrated in a global care model for PLWH living with or having a history of hepatitis C.

Keywords: Aging; Co-infection; Depression; HCV cure; HCV, hepatitis C virus; HIV; Mental health; PHQ-9, Patient Heath Questionnaire-9; PLWH, people living with HIV.

PubMed Disclaimer

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Percentage of HCV-cured people living with HIV affected by the nine depressive symptoms assessed by the PHQ-9. PHQ-9, Patient Heath Questionnaire-9 (cross-sectional survey nested within the ANRS CO13 HEPAVIH cohort study, February 2018–May 2019, N = 398).
See this image and copyright information in PMC

References

    1. Remien R.H., Stirratt M.J., Nguyen N., Robbins R.N., Pala A.N., Mellins C.A. Mental health and HIV/AIDS: the need for an integrated response. AIDS Lond Engl. 15 juill 2019;33(9):1411–1420. - PMC - PubMed
    1. Adinolfi L.E., Nevola R., Rinaldi L., Romano C., Giordano M. Chronic hepatitis C virus infection and depression. Clin Liver Dis. 2017;21(3):517–534. - PubMed
    1. Fialho R., Pereira M., Rusted J., Whale R. Depression in HIV and HCV co-infected patients: a systematic review and meta-analysis. Psychol Health Med. 2017;22(9):1089–1104. - PubMed
    1. Kaur H., Dhiman R.K., Kulkarni A.V., Premkumar M., Singh V., Duseja A.K., et al. Improvement of chronic HCV infection-related depression, anxiety, and neurocognitive performance in persons achieving SVR-12: a real-world cohort study. J Viral Hepat. 2022;29(5):395–406. - PubMed
    1. Pericot-Valverde I., Heo M., Niu J., Norton B.L., Akiyama M.J., Agyemang L., et al. Declines in depressive symptoms among people who inject drugs treated with direct-acting antivirals while on opioid agonist therapy. Open Forum Infect Dis. oct 2020;7(10):ofaa380. - PMC - PubMed

LinkOut - more resources