Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

World J Gastroenterol. 2019 Dec 28;25(48):6928-6938. doi: 10.3748/wjg.v25.i48.6928.


Background: Alterations in health-related quality of life (HRQoL) and neuropsychological disorders were described in the hepatitis C virus (HCV) patients. Although several studies investigated the modifications of HRQoL after HCV eradication, no data exists on the modifications of neuropsychological symptoms.

Aim: To investigate the effect of directly acting antivirals (DAAs) treatment on HRQoL and neuropsychological symptoms.

Methods: Thirty nine patients with HCV infection underwent a neuropsychological assessment, including Zung-Self Depression-Rating-Scale, Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment. HRQoL was detected by Short-Form-36 (SF-36).

Results: All HRQoL domains, but role limitation physical and bodily pain, significantly improved after treatment. Interestingly, after DAAs treatment, all domains of HRQoL returned similar to those of controls. Each neuropsychological test significantly improved after HCV eradication. A significant correlation was observed among each psychological test and the summary components of SF-36. At multiple linear regression analysis including each psychological test as possible covariates, Zung-Self Depression Rating Scale (Zung-SDS) score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.

Conclusion: Neuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.

Keywords: Alexithymia; Depression; Directly acting antivirals; Health related quality of life; Hepatitis C virus; State and trait anxiety.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use*
  • Anxiety / diagnosis*
  • Anxiety / psychology
  • Benzimidazoles / therapeutic use
  • Depression / diagnosis*
  • Depression / prevention & control
  • Depression / psychology
  • Female
  • Fluorenes / therapeutic use
  • Hepacivirus / isolation & purification
  • Hepatitis C / drug therapy*
  • Hepatitis C / psychology
  • Hepatitis C / virology
  • Humans
  • Male
  • Middle Aged
  • Psychological Tests / statistics & numerical data
  • Quality of Life*
  • Self Report / statistics & numerical data
  • Severity of Illness Index
  • Sofosbuvir
  • Treatment Outcome
  • Uridine Monophosphate / analogs & derivatives
  • Uridine Monophosphate / therapeutic use


  • Antiviral Agents
  • Benzimidazoles
  • Fluorenes
  • ledipasvir, sofosbuvir drug combination
  • Uridine Monophosphate
  • Sofosbuvir