Impact of Hepatitis C Virus Cure on Depressive Symptoms in the Human Immunodeficiency Virus-Hepatitis C Virus Coinfected Population in Canada.
| Autor: | Marathe, Gayatri, Moodie, Erica E M, Brouillette, Marie-Josée, Delaunay, Charlotte Lanièce, Cox, Joseph, Martel-Laferrière, Valérie, Gill, John, Cooper, Curtis, Pick, Neora, Vachon, Marie-Louise, Walmsley, Sharon, Klein, Marina B, Cohort, the Canadian Co-Infection |
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| Předmět: |
HIV infection complications
HIV infections RESEARCH CHRONIC hepatitis C CONFIDENCE intervals TIME ANTIVIRAL agents HEPATITIS viruses HEPATITIS C MEDICAL thermometers TREATMENT effectiveness MIXED infections MENTAL depression DESCRIPTIVE statistics CENTER for Epidemiologic Studies Depression Scale ODDS ratio HIV LONGITUDINAL method DISEASE complications |
| Zdroj: | Clinical Infectious Diseases; 2/1/2023, Vol. 76 Issue 3, pe702-e709, 8p |
| Abstrakt: | Background Depression is common in people with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), with biological and psychosocial mechanisms at play. Direct acting antivirals (DAA) result in high rates of sustained virologic response (SVR), with minimal side-effects. We assessed the impact of SVR on presence of depressive symptoms in the HIV-HCV coinfected population in Canada during the second-generation DAA era (2013–2020). Methods We used data from the Canadian CoInfection Cohort (CCC), a multicenter prospective cohort of people with a HIV and HCV coinfection, and its associated sub-study on food security. Because depression screening was performed only in the sub-study, we predicted Center for Epidemiologic Studies Depression Scale-10 classes in the CCC using a random forest classifier and corrected for misclassification. We included participants who achieved SVR and fit a segmented modified Poisson model using an interrupted time series design, adjusting for time-varying confounders. Results We included 470 participants; 58% had predicted depressive symptoms at baseline. The median follow-up was 2.4 years (interquartile range [IQR]: 1.0–4.5.) pre-SVR and 1.4 years (IQR: 0.6–2.5) post-SVR. The pre-SVR trend suggested depressive symptoms changed little over time, with no immediate level change at SVR. However, post-SVR trends showed a reduction of 5% per year (risk ratio: 0.95 (95% confidence interval [CI]:.94–.96)) in the prevalence of depressive symptoms. Conclusions In the DAA era, predicted depressive symptoms declined over time following SVR. These improvements reflect possible changes in biological pathways and/or better general health. If such improvements in depression symptoms are durable, this provides an additional reason for treatment and early cure of HCV. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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