Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH)

Fabienne Marcellin; Sylvie Brégigeon-Ronot; Clémence Ramier; Camelia Protopopescu; Camille Gilbert; Vincent Di Beo; Claudine Duvivier; Morgane Bureau-Stoltmann; Eric Rosenthal; Linda Wittkop; Dominique Salmon-Céron; Patrizia Carrieri; Philippe Sogni; Tangui Barré; ANRS CO13 HEPAVIH Study Group; Scientific Committee; Clinical Centers (ward: participating physicians); Data collection; Management, statistical analyses

doi:10.1016/j.jhepr.2022.100614

Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH)

JHEP Rep. 2022 Oct 28;5(1):100614. doi: 10.1016/j.jhepr.2022.100614. eCollection 2023 Jan.

Authors

Fabienne Marcellin¹, Sylvie Brégigeon-Ronot², Clémence Ramier¹, Camelia Protopopescu¹, Camille Gilbert³, Vincent Di Beo¹, Claudine Duvivier^{4

5

6

7}, Morgane Bureau-Stoltmann¹, Eric Rosenthal^{1

8}, Linda Wittkop^{3

9}, Dominique Salmon-Céron^{10

11}, Patrizia Carrieri¹, Philippe Sogni^{11

12

13}, Tangui Barré¹; ANRS CO13 HEPAVIH Study Group; Scientific Committee; Clinical Centers (ward: participating physicians); Data collection; Management, statistical analyses

Collaborators

D Salmon, R Usubillaga, P Sogni, B Terris, P Tremeaux, C Katlama, M A Valantin, H Stitou, A Simon, P Cacoub, S Nafissa, Y Benhamou, F Charlotte, Virologie S Fourati, I Poizot-Martin, O Zaegel, H Laroche, C Tamalet, G Pialoux, J Chas, P Callard, F Bendjaballah, C Amiel, C Le Pendeven, B Marchou, L Alric, K Barange, S Metivier, J Selves, F Larroquette, E Rosenthal, Infectiologie, A Naqvi, V Rio, J Haudebourg, M C Saint-Paul, A De Monte, V Giordanengo, C Partouche, O Bouchaud, A Martin, M Ziol, Y Baazia, V Iwaka-Bande, A Gerber, M Uzan, A Bicart-See, D Garipuy, M J Ferro-Collados, J Selves, Virologie, F Nicot, A Gervais, Y Yazdanpanah, H Adle-Biassette, G Alexandre, G Peytavin, C Lascoux-Combe, J M Molina, P Bertheau, M L Chaix, C Delaugerre, S Maylin, K Lacombe, J Bottero, J Krause, P M Girard, D Wendum, P Cervera, J Adam, C Viala, D Vittecocq, C Goujard, Y Quertainmont, E Teicher, C Pallier, O Lortholary, C Duvivier, C Rouzaud, J Lourenco, F Touam, C Louisin, V Avettand-Fenoel, E Gardiennet, A Mélard, D Neau, A Ochoa, E Blanchard, S Castet-Lafarie, C Cazanave, D Malvy, M Dupon, H Dutronc, F Dauchy, L Lacaze-Buzy, A Desclaux, P Bioulac-Sage, P Trimoulet, S Reigadas, P Morlat, D Lacoste, F Bonnet, N Bernard, M Hessamfar, J, F Paccalin, C Martell, M C Pertusa, M Vandenhende, P Mercié, D Malvy, T Pistone, M C Receveur, M Méchain, P Duffau, C Rivoisy, I Faure, S Caldato, P Bioulac-Sage, P Trimoulet, S Reigadas, P Bellecave, C Tumiotto, J L Pellegrin, J F Viallard, E Lazzaro, C Greib, P Bioulac-Sage, P Trimoulet, S Reigadas, D Zucman, C Majerholc, M Brollo, E Farfour, F Boué, J Polo Devoto, I Kansau, V Chambrin, C Pignon, L Berroukeche, R Fior, V Martinez, S Abgrall, M Favier, C Deback, Y Lévy, S Dominguez, J D Lelièvre, A S Lascaux, G Melica, E Billaud, F Raffi, C Allavena, V Reliquet, D Boutoille, C Biron, M Lefebvre, N Hall, S Bouchez, A Rodallec, L Le Guen, C Hemon, P Miailhes, D Peyramond, C Chidiac, F Ader, F Biron, A Boibieux, L Cotte, T Ferry, T Perpoint, J Koffi, F Zoulim, F Bailly, P Lack, M Maynard, S Radenne, M Amiri, F Valour, J Koffi, F Zoulim, F Bailly, P Lack, M Maynard, S Radenne, C Augustin-Normand, C Scholtes, T T Le-Thi, L Piroth, P Chavanet, M Duong Van Huyen, M Buisson, A Waldner-Combernoux, S Mahy, A Salmon Rousseau, C Martins, H Aumaître, S Galim, F Bani-Sadr, D Lambert, Y Nguyen, J L Berger, M Hentzien, V Brodard, D Rey, M Partisani, M L Batard, C Cheneau, M Priester, C Bernard-Henry, E de Mautort, P Fischer, P Gantner, S Fafi-Kremer, F Roustant, P Platterier, I Kmiec, L Traore, S Lepuil, S Parlier, V Sicart-Payssan, E Bedel, S Anriamiandrisoa, C Pomes, F Touam, C Louisin, M Mole, C Bolliot, P Catalan, M Mebarki, A Adda-Lievin, P Thilbaut, Y Ousidhoum, F Z Makhoukhi, O Braik, R Bayoud, C Gatey, M P Pietri, V Le Baut, R Ben Rayana, D Bornarel, C Chesnel, D Beniken, M Pauchard, S Akel, S Caldato, C Lions, A Ivanova, A-S Ritleg, C Debreux, L Chalal, J Zelie, H Hue, A Soria, M Cavellec, S Breau, A Joulie, P Fisher, S Gohier, D Croisier-Bertin, S Ogoudjobi, C Brochier, V Thoirain-Galvan, M Le Cam, D Salmon, L Wittkop, P Sogni, L Esterle, P Trimoulet, J Izopet, L Serfaty, V Paradis, B Spire, P Carrieri, M A Valantin, G Pialoux, J Chas, O Zaegel-Faucher, K Barange, A Naqvi, E Rosenthal, A Bicart-See, O Bouchaud, A Gervais, C Lascoux-Combe, C Goujard, K Lacombe, C Duvivier, D Neau, P Morlat, F Bani-Sadr, L Meyer, F Boufassa, B Autran, A M Roque, C Solas, H Fontaine, D Costagliola, L Piroth, A Simon, D Zucman, F Boué, P Miailhes, E Billaud, H Aumaître, D Rey, G Peytavin, V Petrov-Sanchez, A Levier, P Carrieri, M Chalouni, V Conte, L Dequae-Merchadou, M Desvallées, L Esterle, C Gilbert, S Gillet, Q Guillochon, C Khan, R Knight, F Marcellin, L Michel, M Mora, C Protopopescu, P Roux, B Spire, T Barré, C Ramier, A Sow, C Lions, V Di Beo, M Bureau, L Wittkop

Affiliations

¹ Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France.
² Clinical Immunohematology Department, Marseille Public University Hospital System (AP-HM), Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France.
³ ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, Université de Bordeaux, Bordeaux, France.
⁴ Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, APHP-Hôpital Necker-Enfants Malades, Paris, France.
⁵ IHU Imagine, Paris, France.
⁶ Institut Cochin-CNRS 8104-INSERM U1016-RIL Team: Retrovirus, Infection and Latency, Université de Paris, Paris, France.
⁷ Centre Médical de L'Institut Pasteur, Institut Pasteur, Paris, France.
⁸ ANRS I Emerging infectious diseases, Paris, France.
⁹ Service D'information Médicale, CHU de Bordeaux, Pôle de Santé Publique, Bordeaux, France.
¹⁰ Service Maladies Infectieuses et Tropicales, APHP, Hôpital Cochin, Paris, France.
¹¹ Université Paris Descartes, Paris, France.
¹² INSERM U1223, Institut Pasteur, Paris, France.
¹³ Service d'Hépatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France.

Abstract

Background & aims: A growing literature shows an improvement of chronic hepatitis C virus (HCV)-related depression after successful treatment with direct-acting antivirals. However, depression after HCV cure remains insufficiently documented in people living with HIV (PLWH) and HCV, a population with specific mental health challenges. This study aimed to (i) document the prevalence of moderate-to-severe depression (PHQ-9 score ≥10) across different age classes in HCV-cured PLWH; (ii) identify associated socio-behavioral correlates.

Methods: Descriptive analyses were performed on data collected during a cross-sectional survey (February 2018 - May 2019) nested in a prospective, multicenter cohort of individuals living with HIV and HCV (ANRS CO13 HEPAVIH). Socio-behavioral correlates of moderate-to-severe depression were identified using logistic regression.

Results: Among the 398 HCV-cured individuals in the study sample (median age [IQR]: 56 [53-59] years; 73.1% men), 23.9% presented with moderate-to-severe depression (PHQ-9 score ≥10). Depressive symptom prevalence rates were as follows: anhedonia: 52.3%; feeling 'down' or feelings of hopelessness: 48.3%; sleeping problems: 65.7%; lack of energy: 70.3%; eating disorders: 51.2%; lack of self-esteem: 34.3%; difficulty concentrating: 34.9%; sluggishness (in movement and voice) or restlessness: 24.6%; suicidal ideation: 17.1%. No significant difference was detected across age classes. Female sex, unhealthy alcohol use, sedentary lifestyle, and unhealthy eating behaviors were associated with increased odds of moderate-to-severe depression.

Conclusions: Depressive symptoms were common in this sample of HCV-cured PLWH. Unlike findings for the French general population, the prevalence of depression did not decrease with age class. Mental health remains a key issue for HIV-HCV-coinfected individuals, even after HCV cure, especially in women and in individuals with unhealthy behaviors.

Lay summary: Despite potential improvements in mental health after successful treatment with direct-acting antivirals, many people living with HIV (PLWH) and hepatitis C virus (HCV) - even in older age classes - still face depressive symptoms after HCV cure. In this population, women and people reporting unhealthy alcohol use, sedentary lifestyle, or unhealthy eating behaviors are more prone to report depressive symptoms after HCV cure. Mental health and lifestyle-related issues should be integrated in a global care model for PLWH living with or having a history of hepatitis C.

Keywords: Aging; Co-infection; Depression; HCV cure; HCV, hepatitis C virus; HIV; Mental health; PHQ-9, Patient Heath Questionnaire-9; PLWH, people living with HIV.