COMPARISON OF ADHERENCE AND PREVALENCE OF DEPRESSION AMONG HEPATITIS C INFECTED CIRRHOTIC AND NON-CIRRHOTIC PATIENTS TREATED WITH PEGYLATED INTERFERON PLUS RIBAVIRIN VERSUS DIRECT-ACTING ANTIVIRALS

Aikaterini Oikonomou*, Konstantinos Giakoumidakis, Nikolaos V. Fotos, Theodoros Androutsakos, Ioannis Elefsiniotis and Hero Brokalaki

ABSTRACT

Background: Adherence of hepatitis C infected patients to combination therapy of pegylated interferon (PEG-IFN) and ribavirin (RBV) is often inadequate. The, new, all-oral, direct-acting antivirals (DAAs) are expected to exhibit a better adherence profile due to a less complex administration schedule and fewer side effects, including depression. Methods: One hundred and twenty patients with chronic hepatitis C were included in the study. Sixty patients received PEG-IFN plus RBV (Group A) while the remaining sixty patients were treated with DAAs (Group B). Comparison of adherence and prevalence of depression were carried out between the two groups. Additionally, subgroup comparison of adherence and prevalence of depression were conducted between 21 cirrhotic patients from group A and 25 patients with cirrhosis from group B. Patient adherence was estimated with the «A-14 scale» and the prevalence of depression with «Beck Depression Inventory». Results: Patients from group A were found to be less compliant, with higher rates of clinical depression compared to patients from group B (45/60 vs 57/60, p=0.0039 and 37/60 vs 13/60, p<0.0001 respectively). Similarly, HCV-infected cirrhotic patients receiving PEG-IFN and ribavirin were less adherent with higher prevalence of depression compared to HCV-infected cirrhotic patients treated with DAAs (14/21 vs 24/25, p=0.0161 and 15/21 vs 8/25, p=0.0169 respectively). Conclusion: Treatment with DAAs seems to be associated with higher adherence rates and lower rates of depression compared to IFN-based treatment (PEG-IFN plus RBV) in both cirrhotic and non-cirrhotic patients. Consequently, DAAs could help to improve treatment efficacy and quality of life.

Keywords: Depression, direct-acting antivirals, patient adherence, pegylated interferon, ribavirin.