Beyond direct-acting antiviral therapy: Characterizing mental health conditions and depressive symptoms among patients recently treated for hepatitis C

Abstract

The uptake of hepatitis C virus (HCV) treatment, including among under-served populations, has improved significantly in the Direct Acting Antiviral (DAA) era. However, it is unclear whether patients undergoing HCV treatment are receiving adequate support to engage in healthcare for other concurrent conditions. We sought to characterize psychiatric disorders and depressive symptomatology among a cohort of patients recently treated for HCV. We conducted a secondary analysis using data from the Preservation of Sustained Virologic Response (Per-SVR) study, a prospective cohort of individuals who achieved sustained virologic response (SVR) following DAA treatment in British Columbia, Canada. After confirming SVR through receipt of an undetectable HCV viral load test within three months post-treatment, participants were enrolled in the study and completed interviewer-administered surveys. Logistic regression was used to characterize depressive symptoms and psychiatric diagnoses. Among 256 participants, 122 (48%) had significant depressive symptoms and 142 (55%) reported ever having been diagnosed with a psychiatric disorder. Less than half (44%) of those with depressive symptoms had ever been diagnosed with depressive disorder. Participants with depressive symptoms were more likely to report experiencing recent healthcare barriers (adjusted odds ratio: 2.27; 95% confidence interval: 1.02, 5.03). We observed a high prevalence of psychiatric comorbidity among a cohort of patients recently treated for HCV, highlighting an opportunity to engage HCV patients in mental health care. The integration of mental health screening and treatment alongside HCV care may improve health outcomes among HCV-affected populations.