Frontiers in psychiatry · 2026
Long-term psychological and functional outcomes after hepatitis C eradication with direct-acting antivirals: an 80-month follow-up study.
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Cipolla Salvatore, Catapano Pierluigi, Della Corte Maria Chiara, De Francesco Daniele, Volpicelli Antonio, Cafarella Iolanda, Boccia Filomena, Bertolino Lorenzo, Durante-Mangoni Emanuele, Zampino Rosa, Luciano Mario
Аннотация
INTRODUCTION: Direct-acting antivirals (DAAs) have dramatically changed hepatitis C virus (HCV) treatment, by achieving high virological cure rates and a reduced percentage of adverse events compared with previous treatments. Despite this, long-term psychiatric and quality-of-life (QoL) outcomes after viral eradication remain insufficiently understood. This study provides an 80-month follow-up of a previously evaluated cohort.
METHODS: Of the original 62 patients, 24 (38.7%) were reassessed approximately 80 months after DAA initiation. Psychopathological symptoms (HAM-D, HAM-A, SCL-90-R), coping strategies (COPE), and QoL (SF-36) were evaluated and compared with baseline (T0). Patients were stratified by psychiatric history (Group P vs. Group NP). Non-parametric tests and exploratory correlations and regressions were performed.
RESULTS: In Group P, depressive and anxiety symptoms significantly improved from T0 to follow-up (HAM-D: 16 vs. 3, p < 0.01; HAM-A: 15 vs. 4, p < 0.01), with additional reductions in SCL-90-R Interpersonal Sensitivity, Paranoid Ideation, and Psychoticism (all p < 0.05). Group NP showed stable psychological profiles, reflecting the maintenance of improvements already observed at T1, with significant reductions in HAM-D (7 vs. 4, p < 0.01) and HAM-A (8 vs. 4, p < 0.001). Both groups demonstrated a significant decline in SF-36 Physical Component Summary (Group P: p < 0.05; Group NP: p < 0.01). No between-group differences were detected at follow-up. Avoidant coping and psychiatric history were significant negative predictors of long-term anxiety change.
CONCLUSIONS: Seven years after HCV eradication, psychological well-being remains stable or improved, while physical QoL declines. DAAs demonstrate sustained long-term psychiatric safety, underscoring the need for integrated medical-psychological follow-up in HCV survivors.
METHODS: Of the original 62 patients, 24 (38.7%) were reassessed approximately 80 months after DAA initiation. Psychopathological symptoms (HAM-D, HAM-A, SCL-90-R), coping strategies (COPE), and QoL (SF-36) were evaluated and compared with baseline (T0). Patients were stratified by psychiatric history (Group P vs. Group NP). Non-parametric tests and exploratory correlations and regressions were performed.
RESULTS: In Group P, depressive and anxiety symptoms significantly improved from T0 to follow-up (HAM-D: 16 vs. 3, p < 0.01; HAM-A: 15 vs. 4, p < 0.01), with additional reductions in SCL-90-R Interpersonal Sensitivity, Paranoid Ideation, and Psychoticism (all p < 0.05). Group NP showed stable psychological profiles, reflecting the maintenance of improvements already observed at T1, with significant reductions in HAM-D (7 vs. 4, p < 0.01) and HAM-A (8 vs. 4, p < 0.001). Both groups demonstrated a significant decline in SF-36 Physical Component Summary (Group P: p < 0.05; Group NP: p < 0.01). No between-group differences were detected at follow-up. Avoidant coping and psychiatric history were significant negative predictors of long-term anxiety change.
CONCLUSIONS: Seven years after HCV eradication, psychological well-being remains stable or improved, while physical QoL declines. DAAs demonstrate sustained long-term psychiatric safety, underscoring the need for integrated medical-psychological follow-up in HCV survivors.