People who were successfully treated for hepatitis C with direct-acting antiviral (DAA) therapy experienced improvements in their mood and cognition, according to study results published in the Journal of Viral Hepatitis.
Over time, chronic hepatitis C virus (HCV) infection can lead to severe liver disease, including cirrhosis and liver cancer. It has also been linked to neuropsychiatric problems. For example, people with cirrhosis may develop hepatic encephalopathy, wherein toxins in the blood result in impaired brain function.
But sustained virological response (SVR) to antiviral treatment—an undetectable viral load 12 weeks after completing therapy, which is considered a cure—may positively impact neuropsychiatric conditions and quality of life.
Harpreet Kaur, PhD, of the Postgraduate Institute of Medical Education and Research in India, and colleagues conducted a study to explore this association (NCT04330508).
The study population included 385 people with hepatitis C; of these, 59% had HCV genotype 3. Three quarters were men, and 21% had liver cirrhosis. Participants were between ages 18 and 65 years; the average age was 39. Most acquired HCV via unsterile injections, surgery or injection drug use.
At baseline and at 12 weeks after completing antiviral therapy, the participants underwent a series of tests that assessed mood, anxiety and quality of life as well as other cognitive factors. Irrespective of cirrhosis status, they showed significant declines in cognitive function at baseline compared with healthy individuals and those with non-alcoholic fatty liver disease (NAFLD).
Some 91% of participants achieved SVR; 88% of people with cirrhosis and 91% of people without cirrhosis were cured.
Those who attained SVR had less depression and anxiety along with improved concentration, reaction time, processing skills and visual, short-term and working memory. People who were not cured, however, saw either no improvements or a decline in these cognitive and mental health measures. When the researchers compared cognitive function in people with HCV versus those with NAFLD, the former performed more poorly.
“In conclusion, given the cumulative evidence of the safety of DAAs and efficacy of improving cognitive and neuropsychological and quality-of-life outcomes irrespective of age and gender, as shown in our study, future recommendations should focus on integrated universal HCV care to enable HCV elimination,” wrote the researchers.