Anxiety, Depression, Fatique and Necroinflammatory Activity in Chronic Hepatitis B Patients: A Cross-sectional Study

Background Patients with chronic Hepatitis B (CHB) are more likely to experience mental health issues, which can become worse by liver fibrosis and inflammation. This study aimed to investigate the association of CHB-related necroinflammation and fibrosis on these psychiatric symptoms. Methods A cross-sectional analysis was conducted on 200 CHB patients. The degree of liver inflammation and fibrosis was evaluated using non-invasive (AAR, APRI, FIB-4, API) scores. Patients were asked to complete the HADS and FSS measures in order to gauge their psychological condition. Results In this study, 200 patients were examined. Anxiety was present in 6.5%, depression in 21%, and increased fatigue severity in 27%. AAR was significantly higher in patients with depression (p=0.008). FIB-4 score was significantly higher in those with anxiety (p=0.037) and showed a limited significant difference in fatigue (p=0.052). APRI values were significantly higher in the increased fatigue severity group (p=0.004). Multivariate analyses showed that liver fibrosis significantly increased the risk of depression (OR=2.35, p=0.036), and increasing age decreased the risk of depression (p=0.025). Significantly lower anxiety risk was associated with marriege (OR=0.06, p=<0.001). Patients on antiviral therapy had a 2-fold increase in fatigue severity (OR=2.07, p=0.027). Conclusions This study highlights the link between psychiatric symptoms and liver disease progression in CHB patients. The observed associations between liver fibrosis, depression, and fatigue underscore the importance of a holistic approach to CHB management that integrates mental health support. Such an approach may improve patient outcomes and overall quality of life.