Background: Depression is the most common extrahepatic neuropsychiatric manifestation in chronic hepatitis C (CHCV) and is due to direct neuropathogenic mechanisms. Our aim is to evaluate the effect of viral clearance by directly acting antivirals (DAAs) on depression in CHCV patients.
Methods: One hundred fifty chronic HCV patients eligible for DAAs were assessed for depression using the Beck depression inventory (BDI) scale at baseline, 1 and 3 months after end of treatment (EOT). BDI ≥10 reliable in detecting depression in CHCV.
Results: All included patients received Sofosbuvir/Dacltasvir ± Ribavirin for 12 weeks and all achieved sustained virological response (SVR). Baseline BDI of all included patients was 10 ± 5 then decreased to 5.3 ± 5 and 3.5 ± 4.5 at 1 and 3 months after EOT (P = 0.001), respectively. After EOT, 20 patients (13.3%) had BDI >10 which were 11.35 ± 6.5 and 13.3 ± 3.2 at 1 and 3 months (SVR), respectively. A comparison between patients with high and low BDI after EOT showed that patients with persistent high score were older (60.6 ± 9.5vs 52.2 ± 10.6, P = 0.001) and included higher percentage of females (50% vs 22.3%, P = 0.01). Also high BDI patients had higher baseline FIB4 (3 ± 1.6 vs 2 ± 1.3, P = 0.006) and included more patients with significant fibrosis (40% vs 17.7%, P = 0.05), as well as lower baseline hemoglobin (13.6 ± 1.5 vs 14.4 ± 1.65, P = 0.04).
Conclusion: Depression associated with CHCV improves after successful treatment with DAAs; however, it may persist in elderly females with significant fibrosis and low hemoglobin.
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