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

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)-naive DAA group, retreatment (re-Tx) DAA group, and Tx-naive 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-naive DAA group and Tx-naive IFN group and 3,792 pairs from the re-Tx DAA group and Tx-naive IFN group. A lower incidence of NPDs was observed in the Tx-naive DAA group than in the Tx-naive 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-naive 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-naive CHC patients in a 6-month period after treatment completion, especially among the patients less than 65 years, male gender, and cirrhosis.

Automated summary

This retrospective cohort study used Taiwan's National Health Insurance Research Database to evaluate the difference in incidence of neuropsychological disorders (NPDs) between chronic hepatitis C patients receiving interferon therapy and direct-acting antivirals (DAAs) therapy. The study found that patients receiving DAA therapy had a lower risk of NPDs compared to those receiving interferon therapy during the 6-month period after treatment completion.