Frequency of Depression in Patients Taking Direct-Acting Antivirals for Hepatitis C

Abstract

Hepatitis C virus (HCV) remains a significant public health challenge globally and in Pakistan, where the disease burden is high and mental health concerns frequently go unrecognized. Although direct-acting antivirals (DAAs) have significantly improved treatment outcomes, the psychological impact of these therapies, particularly depression, remains a significant clinical consideration. Objective: To determine the frequency of depression among patients receiving direct-acting antiviral therapy for hepatitis C at a tertiary care Liver Center in Pakistan. Methods: A cross-sectional study was conducted at the Liver Center, DHQ Hospital, Faisalabad Medical University, over 3 months from January 1st, 2025, to March 31st, 2025. Using non-probability consecutive sampling, 84 patients aged 18–50 years with PCR-confirmed hepatitis C infection who had been on DAA therapy for 2–3 weeks were enrolled. Patients with prior interferon exposure, psychiatric illness, co-infections, or other chronic systemic diseases were excluded. Depression was assessed using DSM-5 criteria via structured clinical interviews. Data were analyzed using SPSS 23, with frequencies, percentages, means, and standard deviations calculated. Stratification and chi-square tests were performed at the p ≤ 0.05 significance level. Results: The mean age of participants was 34.8 ± 8.1 years, and 52.4% were female. Most belonged to urban regions (58.3%) and low socioeconomic status (57.1%). Depression was identified in 27 patients, yielding a frequency of 32.1%. Depression was more common among females (40.9%), patients aged 31–40 years (37.5%), and those from low socioeconomic backgrounds (41.7%), although only socioeconomic status demonstrated a statistically significant association (p = 0.04). Comorbidities and gender did not show significant associations with depression. Conclusion: Nearly one-third of hepatitis C patients undergoing DAA therapy experienced depressive symptoms during the early phase of treatment. Socioeconomic vulnerability emerged as a significant contributor. These findings highlight the need for integrated mental health screening, early psychosocial intervention, and patient-centered support within hepatitis C management programs in Pakistan.