PHOBIAS IN SUCESSFULLYTREATED HCVPATIENTS- MALHOTRA SYNDROME

Introduction: Chronic hepatitis C virus (HCV) infection is important cause for cirrhosis of liver all over the world and many patients suffering from this deadly disease require liver transplantation as the definitive treatment. The oral directly acting antiviral for treatment has changed management of its treatment in a significant way, as these drugs like interferon can be used even in decompensated cirrhotic stage.

Aims and Objectives:To determine the fear and apprehensions in Chronic HCV patients who have been successfully treated and achieved sustained virological response (SVR) on oral antiviral drugs compliance among patients who were treated with directly acting oral antiviral drugs (Sofosbuvir 400 mg, Daclatasvir 60 mg, Velpatasvir 100 mg).

Materials & Methods:It was prospective study conducted at Department of Medical Gastroenterology, Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, over a period of five years from 01.11.2019 to 31.10.2024. Out of six thousand patients of Chronic hepatitis C who reported in department in above five years duration, 600 patients pre therapy HCV RNA was not detected hence they were not treated and were not part of the study. Out of the remaining 5400 patients, 5130 patients (95%) achieved SVR. Out of these 5130, in next five years period, 1100 patient came back for consultation for positive anti HCV antibody test which was done for some other purpose like blood donation or before surgery. Fifteen hundred (1500) patientcame back for consultation for complaints like myalgia, pain abdomen, dyspepsia, insomnia, itching etc. and thought it to be due to reinfection with HCV virus and requested for repeat HCV RNA Quantitative test which was done and only in ten patients HCV RNA was detected and in rest 1490, it was negative.

Results:Out of 5130 patients, 2600 (50.68%) came back on their own for retesting in five years duration, just due to phobia of reinfection with HCV, as they attributed all their minor complaints to HCV but in reality, and as per scientific rationale has no relation with the same. This Phobia of recurrence of HCV is most common reason for unwarranted anxiety in them and brings them back for retesting, as they feel that their treatment is failed. On daily basis, author meet at least five SVR achieved patients having this phobia of recurrence of HCV and has termed it as MALHOTRA SYNDROME.