Hepatitis C and Depression
Last updated: March 2023
In the 2020 Hepatitis C In America Survey, 53% of those infected with hepatitis C reported depression as a symptom and 43% also reported anxiety or panic disorders. This figure is somewhat higher than percentages reported in other sources, that use a figure of 33% or somewhat higher1,2.
Does hep C cause depression?
Why those infected with HCV report higher levels of depression than the general public (which according to the CDC, is 4.7% in adults 18 and older) is not well understood.3 There is evidence that hepatitis C may change the chemical balance in our brains increasing the susceptibility to depression. In the chronic HCV phase, there is an increase in inflammatory cytokines that can cause neuropsychiatric manifestations, thus the virus itself might cause changes to the brain and a resulting increase in depressive symptoms. More research is needed to better understand this connection and its impact on HCV patients.4
Depression as a side effect of treatment
Both peginterferon and ribavirin commonly used for treatment up to 5 -10 years ago have documented side effects including mood swings and depressive symptoms. These depressive conditions, many the result of interferon treatments, may decline DAA’s become more widely used method to treat Hepatitis C.
New hep C treatments have fewer side effects
In the United States and many other countries, direct acting antivirals (DAA’s) that are free of interferon and ribavirin are the preferred treatment. They appear to have fewer side effects than the earlier treatment and a lower risk of depressive manifestations. Their treatment length is much shorter, typically lasting 8-14 weeks. Recent research indicates that for those who have completed DAA treatment and are cured, there is a reduction or elimination of depression.1 While the use of DAA’s appears to have a positive effect in the reduction of depressive episodes that were accentuated by interferon treatment, it’s not yet clear how significant the total reduction in depression among HCV-infected individuals will be until the impact of the virus and the cytokines on the brain are established. his is also important since many infected individuals don’t have access to, can’t afford, or won’t get treated and may suffered from depressive manifestations.
How hep C affects mental health
Of course there is also the reality that a hepatitis C diagnosis in itself is disturbing and the ramifications of the disease can be very consequential and disruptive, both potential causes for a depressive episode or long term condition and increased levels of anxiety. Many research papers indicate that anxiety may be as common among HCV patients as depression. One study reported a that 24% of HCV patients reported they has anxiety disorder.5 Unfortunately these disorders are often overlooked by medical personnel, but help is available!