Treating patients with psychiatric disorders for hepatitis C

Dec 03, 2007

People with severe mental illnesses are far more likely to be infected with Hepatitis C virus compared to the general population, however, they often do not get treatment for their liver disease because current antiviral therapies have known psychiatric side effects.

“Against this epidemiological background, the article by Schaefer and colleagues, Hepatitis C treatment in psychiatric risk patients, represents an important study in the field,” write Sanjeev Arora and Cynthia Geppert, in the December issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). Their editorial is also available online at Wiley Interscience.

“It provides an even stronger empirical foundation for the findings of other less methodologically rigorous studies showing that patients with HCV and comorbid psychiatric and substance use disorders have comparable sustained viral responses (SVR) and rates of depression when treated with antiviral therapies,” Arora and Geppert report.

While the National Institutes of Health once advised doctors against treating HCV-infected patients who continued to use illicit drugs, drink alcohol, or who had a psychiatric history, in 2002, the agency released a statement that said “efforts should be made to increase the availability of the best current treatments” to those patients.

Research has shown this approach to be feasible and effective, and it also has important implications for public health. Still, doctors have been slow to act on the recommendation.

Arora and Geppert applaud Shaefer et. al’s work with very difficult to treat patients and point out that the key to their success was the use of a multidisciplinary team. “The patients in this study were carefully screened and monitored and received extensive education and counseling,” they point out. They also praise the work because it assessed both depressive and psychotic symptoms and demonstrates that neither diagnosis adversely affected SVR or outcome. Instead, the study adds to the growing body of evidence that shows using anti-depressant agents prior to and during HCV treatment can lessen, or even prevent, depressive reactions.

While Arora and Geppert point out that the small sample size in Schaefer et. al’s study means that the conclusion that there is no difference in SVR between controls and patients with mental health diagnosis is stronger than the data can support, they praise the forward-thinking nature of the work.

“The value of Schaefer et al.’s work is precisely in contributing to the growing body of data that challenge hepatologists and mental health professionals to develop new medications and innovative programs that can further widen the door to admit these patients to HCV treatment,” the authors conclude.

Related link: www.interscience.wiley.com/journal/hepatology

Source: Wiley-Blackwell

Explore further: Osteoporosis screening guidelines miss many younger post-menopausal women

add to favorites email to friend print save as pdf

Related Stories

Stress research in therapy dogs reveals animals' needs

Apr 29, 2014

Animals exert positive effects on humans. This fact has been proven scientifically and is used increasingly often for specific therapeutic purposes. Scientists at the Vetmeduni Vienna investigated how therapy ...

Pilots' mental health a concern amid jet mystery

Mar 23, 2014

Reinforced doors with keypad entries. Body scanners and pat-downs. Elaborate crew maneuvers when a pilot has to use the restroom. All those tactics are designed to keep dangerous people out of the cockpit. ...

Recommended for you

WHO: Ebola vaccine trials in W. Africa in January

6 hours ago

Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe, a top World Health Organization official ...

Ebola cases rise sharply in western Sierra Leone

6 hours ago

After emerging months ago in eastern Sierra Leone, Ebola is now hitting the western edges of the country where the capital is located with dozens of people falling sick each day, the government said Tuesday. So many people ...

User comments : 0