- A Canadian study found nearly half of people cured of hepatitis C had depression symptoms
- People with depression were three times more likely to report difficulty accessing healthcare
- Researchers called to integrate mental health screening alongside hepatitis C care
Hepatitis C virus can be spread in ways similar to HIV. Affected populations in Canada include some people who have emigrated from countries where HCV is relatively common and who were exposed at birth, through improper sterilization of surgical equipment or via contaminated blood. Other populations disproportionately affected by HCV in Canada include people who share equipment for drug use, people who have been imprisoned and some Indigenous people.
If left undiagnosed and untreated, HCV can cause chronic infection of the liver. The virus causes inflammation in this vital organ. Healthy liver tissue is gradually replaced with scar tissue. Eventually the liver becomes increasingly inflamed and dysfunctional, leading to persistent fatigue, an increased risk of internal bleeding and abdominal infections. In some cases, waste products build up in the blood, affecting the functioning of the brain. Problems with memory and thinking clearly occur. As scar tissue accumulates, the risk of liver cancer increases.
HCV infection can be diagnosed with simple blood tests. Treatment available today for HCV is simple and consists of once-daily oral dosing for two to three months. What’s more, treatment is highly effective, with studies reporting cure rates of at least 95 per cent.
In British Columbia
A team of researchers in British Columbia has been interviewing people who have recently been cured of HCV with oral treatment (within the past three months). They were interviewed in person or over the telephone by study personnel.
A total of 256 participants were recruited between April 2017 and December 2024 from the following places:
- hospitals
- clinics
- pharmacies
- community organizations
- supervised consumption sites
As part of the survey process, researchers used a set of questions that have been validated for screening people for depression.
The average profile of participants was as follows:
- age – 51 (the range was 22 to 85 years)
- more than 99% were cisgender (64% male, 35% female)
- major ethno-racial groups: White – 62%; Indigenous – 25%
- 84% had been incarcerated in the past
- 80% had experienced homelessness in the past
Results
Researchers found that nearly half of the participants (122 people) had symptoms of depression. However, only 44% of these 122 people had ever been diagnosed with depression in the past.
People who had depression were three times more likely to report recent difficulty in accessing healthcare compared with people who did not have depression. Some of these difficulties were caused by problems within the healthcare system. The researchers, some of whom were also physicians, stated that healthcare-associated barriers to care included “poor treatment by healthcare professionals [and] long waitlists.”
For the future
The findings from this B.C. study underscore a potential gap in mental health screening and healthcare in people who have been treated for HCV. The researchers stated that “addressing this unmet need is vital for recently treated individuals who are vulnerable to reinfection, as there is evidence to support that receiving mental health care reduces the risk of HCV infection [in other studies].”
Depression can cloud a person’s judgment and rob them of energy and agency. These effects can make accessing healthcare challenging.
The researchers encourage health systems to integrate “routine mental health screening and treatment alongside HCV care. This strategy could streamline the diagnosis and management of depression and other psychiatric conditions among HCV-affected populations.” Other benefits from integrating care could help reduce the risk of HCV reinfection and improve overall health and quality of life.
Note that there have been many large studies of oral HCV treatment in the current era. Such treatment does not cause depression. Although participants were not surveyed at multiple points over a long period, it is likely that they had depression prior to initiation of HCV treatment.
—Sean R. Hosein
Resources
Hepatitis C: an in-depth guide – CATIE
Large study finds many benefits arise from curing hepatitis C virus – CATIE News
REFERENCES:
- Kelly SE, Ajidahun A, Bytelaar S, et al. Beyond direct-acting antiviral therapy: Characterizing mental health conditions and depressive symptoms among patients recently treated for hepatitis C. PLoS One. 2026 Mar 17;21(3):e0344862.
- Tiwana A, Twohig KA, Fraser M, et al. Sexually transmitted and bloodborne infections testing among people who use substances: findings from the 2023 British Columbia Harm Reduction Client Survey. BMC Infectious Diseases. 2026; in press.