Cognitive–Affective Dimension After Virological Cure of Hepatitis C Virus Infection: WBSI Dynamics, Liver Status, and the Role of Comorbidities

Introduction: Virological cure in chronic infection with hepatitis C virus (HCV) is followed by important clinical and biological benefits, including psychological ones. The White Bear Suppression Inventory (WBSI) assesses the tendency to suppress intrusive thoughts and was used in this study as a tool to provide a cognitive–affective assessment of patients with chronic HCV infection—both at the start of antiviral therapy and five years after achieving virological cure. Objective: This study aimed to characterize patients with HCV infection who received antiviral therapy and completed the WBSI, to assess longitudinal changes in WBSI scores, and to identify clinical, biological, and comorbidity-related factors associated with these changes. Methods: The study employed an ambispective observational longitudinal cohort study design conducted on a sample of 386 patients, of whom 81 completed the WBSI both at baseline and at follow-up. Results: The WBSI subsample did not differ significantly from the remainder of the cohort in terms of age, cytolysis markers, bilirubin, albumin, platelet count, or major comorbidities. The WBSI score decreased significantly from baseline to follow-up, from 61.36 to 54.16, with a mean difference of 7.20 points (t = 6.32; p < 0.001). The correlation between the baseline and follow-up scores was very strong (r = 0.899; p < 0.001), indicating substantial interindividual stability. ΔWBSI was weakly but significantly correlated with the change in total bilirubin (r = 0.254; p = 0.022), with no significant correlations with the other biological markers. In the multivariable model, cardiovascular comorbidities (B = −8.469; p < 0.001) and metabolic comorbidities (B = −9.869; p = 0.002) were independent negative predictors of WBSI scoring, whereas fibrosis evolution, age, sex, and baseline total bilirubin had no significant influence. Conclusions: Improvements in WBSI scores observed only in specific patient subgroups, one year after achieving HCV virological cure, underscore the need to integrate psychological assessment into long-term monitoring, particularly for patients with cardiovascular and metabolic comorbidities.