Neuropsychiatric disorders in chronic hepatitis C patients after receiving interferon or direct-acting antivirals: a nationwide cohort study

Frontiers in Pharmacology

Pharmacology

Pei-Chin Lin¹  Hsien-Chung Yu²  Chung-Yu Chen³  Yu Fang⁴ 

[1] Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan;Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan;Department of Business Management, Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung, Taiwan;Department of Nursing, Meiho Institute of Technology, Ping-Tung, Taiwan;Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Pharmacy, Pingtung Veterans General Hospital, Pingtung, Taiwan;

关键词: hepatitis C virus;    direct-acting antivirals;    neuropsychological disorders;    anxiety;    depression;   

DOI  :  10.3389/fphar.2023.1191843

 received in 2023-03-22, accepted in 2023-07-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background: Data on the neuropsychological outcomes after receiving direct-acting antivirals (DAAs) among chronic hepatitis C (CHC) patients have not been well-documented.Aim: This study aimed to evaluate the difference in incidence of neuropsychological disorders (NPDs) after treatment completion between CHC patients receiving interferon (IFN) therapy and DAA therapy.Methods: A nationwide retrospective cohort study was performed using Taiwan’s National Health Insurance Research Database (NHIRD) between 2010 and 2018. CHC patients without pre-existing mental disorders were included and divided into the treatment (Tx)-naïve DAA group, retreatment (re-Tx) DAA group, and Tx-naïve IFN group based on their HCV therapy. Propensity score matching was used to balance baseline differences between groups. The primary outcome was the incidence of NPDs during 6 months after completion of therapy.Results: After one-to-one matching, there were 6,461 pairs of patients selected from the Tx-naïve DAA group and Tx-naïve IFN group and 3,792 pairs from the re-Tx DAA group and Tx-naïve IFN group. A lower incidence of NPDs was observed in the Tx-naïve DAA group than in the Tx-naïve IFN group (HR = 0.72, 95% CI = 0.55–0.94, and p = 0.017). The risk of NPDs did not differ between the re-Tx DAA group and the Tx-naïve IFN group (HR = 0.74, 95% CI: 0.52–1.05, and p = 0.092).Conclusion: DAA therapy was associated with lower risk of NPDs when compared with IFN therapy among Tx-naïve CHC patients in a 6-month period after treatment completion, especially among the patients less than 65 years, male gender, and cirrhosis.

【 授权许可】

Unknown   
Copyright © 2023 Fang, Chen, Yu and Lin.