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Depression, poor mental health linked to stress, antiviral therapy in HCV patients

Depression and poor mental and physical health were associated with stressful life events, low social support and other socioeconomic and demographic factors in patients with hepatitis C virus infection enrolled in the Chronic Hepatitis Cohort Study. 

“The focus of the current study is to assess the quality of life of patients with chronic hepatitis C infection, especially the prevalence of current depression and poor health status as these relate to HCV treatment history and the course of the disease, in the largest sample of U.S. patients to date” the researchers wrote.

Researchers analyzed data of 4,781 surveyed patients (mean age, 56.7 years) with HCV, to determine any risk factors for depression and poor physical health, according to the research. The survey collected data related to demographic information, employment status, self-reported psychoactive substance abuse, and other data. In addition, the PHQ-8 and SF-8 scales were used to measure quality of life.

Of the patients, 51.4% reported past injection drug use, 33.9% were smokers and 17.7% had a history of alcohol abuse in the past year. Overall, 29.7% of patients were depressed according to the PHQ-8 scale and 24.6% had poor physical health according to the SF-8 scale.

Bivariate analyses showed depression to be associated with a history of injection drug use, alcohol rehabilitation, drug abuse treatment, being a smoker and being uninsured. Further analyses showed depression linked to exposure to stressful life events within a year of the study, low social support within a year of the study, higher Charlson Comorbidity Index scores and currently receiving HCV therapy. Patients who reached SVR from a previous 12-week regimen for HCV were less likely to be depressed, according to the research. Poor physical health according to the SF-8 scale was also associated with income, education, marital status and other socioeconomic factors (P < .001).

Multivariate logistic regression analysis showed current employment status, moderate or highly stressful life events and low or moderate social support as predictors of depression (P < .001). A previously achieved SVR from antiviral therapy had a protective effect on depression (P = .008), according to the research.    

“The impact of many behavioral, psychosocial and treatment factors on functional mental and physical health status in chronic HCV patients is complex,” the researchers concluded. “We expect that even with the advent of interferon-free all-oral HCV treatments, psychosocial and socioeconomic factors will continue to be an important consideration in assessing patient outcomes, risks and costs.”

Disclosure: Boscarino reports no relevant financial relationships. Another researcher reports relationships with AbbVie, Amgen, BMS, CVS Caremark, Gilead, GlaxoSmithKline, Intercept, Merck, Novartis. Tibotec/Janssen and Verte.