Co-occurring Depression, Chronic Pain and Substance Use Disorders in People with Hepatitis C

Elizabeth Chereji1, Shira Kern1, Bret Fuller2, 3, Benjamin J. Morasco2, 3, Alissa Phelps2, Peter Hauser1, 4, 5, 6, *
1 Mental Health, Long Beach VA Medical Center, CA, 90822, USA
2 Mental Health and Clinical Neurosciences Division, VA Portland Health Care System, Portland, USA
3 Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
4 VISN 22 Network Office, Long Beach, California, USA
5 Department of Psychiatry and Human Behavior, University of California-Irvine, Irvine, California, USA
6 Department of Psychiatry, University of California San Diego, San Diego, California, USA

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Creative Commons License
© Chereji et al. ; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the 300 Oceangate, Suite 700, Long Beach, California 90802, USA; Tel: 562-826-8000. x2629; E-mail:


Chronic infection with Hepatitis C virus (HCV) is common and can result in serious and sometimes fatal liver complications. The impact of HCV on the liver can be further complicated by medical and psychological comorbidities. Depression, substance use, and pain syndromes are frequent co-morbid conditions in people with HCV and diminish functioning, quality of life, and treatment compliance. Understanding the underlying biological mechanisms of these comorbid conditions within the context of HCV may help elucidate factors contributing to their co-occurrence, perhaps mediated via pro-inflammatory cytokines. The current review provides a synthesis of the literature on depression, substance use disorders and chronic pain in the presence of HCV. The review includes studies conducted with both veteran and civilian populations. The implications for assessment and antiviral treatment of HCV will be considered.

Keywords: Depression, Hepatitis C, Pain, Substance Use.