In chronic hepatitis C (CHC) patients, interferon-based treatments showed toxicity, limited efficacy, and psychiatric manifestations. Direct-acting antiviral (DAA) agents appeared safer, though it remains unclear if they may exacerbate or foster mood symptoms in drug-naïve CHC patients. We evaluated 62 CHC patients’ mental status, before and 12 weeks after DAA therapy, by assessment scales and psychometric instruments. We subdivided patients into two groups, CHC patients with (Group A) or without (Group B) a current and/or past psychiatric history. After DAA treatment, Group A patients showed low anxiety and improved depression, no variation in self-report distress, but worse general health perceptions. No significant difference emerged from coping strategies. Depression and anxiety improved in Group B, and no change emerged from total self-reported distress, except for somatization. Moreover, Group B increased problem-focused strategies for suppression of competing activities, and decreased strategies of instrumental social support. Contrarily, Group B reduced significantly emotion-focused strategies, such as acceptance and mental disengagement, and improved vitality, physical and social role functioning. DAA therapy is safe and free of hepatological and psychiatric side effects in CHC patients, regardless of current and/or past psychiatric history. In particular, patients without a psychiatric history also remarkably improved their quality of life.

中文翻译：

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直接作用抗病毒药物对慢性丙型肝炎患者心理健康的影响：一项前瞻性观察研究。

在慢性丙型肝炎 (CHC) 患者中，基于干扰素的治疗显示出毒性、疗效有限和精神症状。直接作用抗病毒 (DAA) 药物似乎更安全，但目前尚不清楚它们是否会加剧或促进初治 CHC 患者的情绪症状。我们通过评估量表和心理测量仪器评估了 62 名 CHC 患者在 DAA 治疗前和治疗后 12 周的精神状态。我们将患者分为两组，即有（A 组）或无（B 组）当前和/或既往精神病史的 CHC 患者。DAA 治疗后，A 组患者的焦虑程度较低，抑郁程度有所改善，自我报告的痛苦没有变化，但总体健康认知较差。应对策略没有出现显着差异。B 组的抑郁和焦虑有所改善，除了躯体化之外，自我报告的总体痛苦没有任何变化。此外，B组增加了以问题为中心的抑制竞争活动的策略，并减少了工具性社会支持的策略。相反，B 组显着减少了以情绪为中心的策略，例如接受和精神脱离，并提高了活力、身体和社会角色功能。无论当前和/或过去的精神病史如何，DAA 治疗对于 CHC 患者都是安全的，并且不会产生肝脏和精神副作用。特别是，没有精神病史的患者的生活质量也显着改善。