SVR in HCV associated with decreased psychiatric hospitalizations

Patients with hepatitis C who achieved sustained virologic response through direct-acting antiviral therapy experienced a decrease in psychiatric hospitalizations after treatment, according to a presenter at The Liver Meeting Digital Experience.

“DAAs have been shown to reduce liver-related mortality in patients with chronic HCV. However, their effects on non-hepatic health conditions, including psychiatric health care utilization, remain understudied,” Claire Durkin, MD, first-year gastroenterology fellow at the hospital of the University of Pennsylvania, said during the presentation. “The goal of our study was to evaluate the impact of HCV treatment with DAAs on mental health-related inpatient health care utilization in a cohort of U.S. veterans.”

In the retrospective cohort study, Durkin and colleagues evaluated data from 104,838 patients with HCV viremia who were treated with DAAs within the Veteran’s Health Administration between January 2014 and August 2020. Discharge ICD-9 or ICD-10 diagnoses were used to classify inpatient hospitalization at VA facilities.

Of the patients included within the study, 82.3% achieved SVR, 8.13% remained viremic and 9.57% had an unknown post-treatment SVR status. Within the cohort, 19.79% of patients had compensated cirrhosis, 7.39% had decompensated cirrhosis and 72.82% did not have a diagnosis of cirrhosis.

The study cohort experienced an overall decrease in psychiatric hospitalizations in the 3 years after treatment compared with the 3 years preceding treatment (3.54% vs. 5.15%; P < .0001), with the number of hospitalizations increasing in the years leading up to treatment and decreasing in the years following treatment for both patients with and without cirrhosis.

“Interestingly, these findings were particularly pronounced when stratifying by SVR status. In those who achieved SVR, we saw a marked decrease in psychiatric hospitalizations in the 3 years before vs. after treatment,” Durkin said.

Among patients who achieved SVR through DAA therapy, 3.5% were hospitalized in the 3 years after treatment, as compared with 4.84% in the 3 years before treatment (P < .0001). However, patients who had undergone DAA therapy but did not achieve SVR had similar rates of psychiatric hospitalizations both before and after treatment (6.83% vs. 6.49%; P = .703)

“These findings demonstrate that SVR was associated with a decrease in inpatient psychiatric hospitalization and suggest valuable non-hepatic effects of HCV elimination. Additional studies are needed to further characterize the effects of DAA therapy on mental health related morbidity, mortality costs and outpatient health care utilization,” Durkin said.