Comparative Effectiveness of Direct-Acting Antivirals for Posttraumatic Stress Disorder in Veterans Affairs Patients With Hepatitis C Virus Infection
Abstract
We recently conducted an exploratory study that indicated that several direct-acting antivirals (DAAs), highly effective medications for hepatitis C virus (HCV) infection, were also associated with improvement in posttraumatic stress disorder (PTSD) among a national cohort of US Department of Veterans Affairs (VA) patients treated between October 1, 1999, and September 30, 2019. Limiting the same cohort to patients with PTSD and HCV, we compared the associations of individual DAAs with PTSD symptom improvement using propensity score weighting. After identifying patients who had available baseline and endpoint PTSD symptom data as measured with the PTSD Checklist (PCL), we compared changes over the 8–12 weeks of DAA treatment. The DAAs most prescribed in conjunction with PCL measurement were glecaprevir/pibrentasvir (GLE/PIB; n = 54), sofosbuvir/velpatasvir (SOF/VEL; n = 54), and ledipasvir/sofosbuvir (LDV/SOF; n = 145). GLE/PIB was superior to LDV/SOF, with a mean difference in improvement of 7.3 points on the PCL (95% confidence interval (CI): 1.1, 13.6). The mean differences in improvement on the PCL were smaller between GLE/PIB and SOF/VEL (3.0, 95% CI: −6.3, 12.2) and between SOF/VEL and LDV/SOF (4.4, 95% CI: −2.4, 11.2). While almost all patients were cured of HCV (92.5%) regardless of the agent received, PTSD outcomes were superior for those receiving GLE/PIB compared with those receiving LDV/SOF, indicating that GLE/PIB may merit further investigation as a potential PTSD treatment.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Jun 11, 2022
- Source ID
- 10.1093/aje/kwac104
Entities
People
- Bradley V. Watts
- Brian Shiner
- Jack Esteves
- Jaimie L Gradus
- Jenna Forehand
- Jessica E. Hoyt
- Jiang Gui
- Krista F Huybrechts
- Kristen Ray
- Luke Rozema
- Paula P Schnurr
- Tammy Jiang
Organizations
- Brigham and Women's Hospital
- Eli Lilly and Company
- National Institute of Mental Health
- National Institutes of Health
- United States Department of Defense
- United States Department of Veterans Affairs