Determining rates of hepatitis C in a clozapine treated cohort

Sockalingam, Sanjeev; Shammi, Chekkera; Powell, Valerie; Barker, Lucy; Remington, Gary

doi:10.1016/j.schres.2010.06.005

Cited by 11 publications

(6 citation statements)

References 29 publications

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“…HCV Ab prevalence among outpatients of CAMH was higher compared to the public and staff (2.6% [ n = 5/192] vs. 1.0% [ n = 17/1696]), consistent with published data that show that HCV prevalence is higher in marginalized populations, particularly those with substance use and mental health disorders. [ 7 , 8 , 9 ] In individuals who declined to identify as patients, staff, or members of the public, the prevalence was 2.1% (9/429).…”

Section: Resultsmentioning

confidence: 99%

Leveraging corona virus disease 2019 vaccination to promote hepatitis C screening

Vanderhoff

Smookler

Biondi

et al. 2022

Hepatology Communications

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Health care initiatives, such as hepatitis C virus (HCV) screening, have been greatly overshadowed by the corona virus disease 2019 (COVID‐19) pandemic. However, COVID‐19 vaccination programs also provide an opportunity to engage with a high volume of people in a health care setting. We collaborated with a large COVID vaccination center to offer HCV point‐of‐care testing followed by dried blood spot collection for HCV RNA. Additionally, this opportunity was used to evaluate the practical significance of a 5‐minute version of the OraQuick HCV antibody test in lieu of the standard 20‐minute test. We tested 2317 individuals; 31 were HCV antibody positive and six were RNA positive of which four were treated and reached sustained virological response. Over a third of those surveyed said they would not have participated had the test required 20 minutes. Conclusion : Colocalizing HCV testing and linkage to care at a COVID vaccination clinic was found to be highly feasible; furthermore, a shortened antibody test greatly improves the acceptance of testing.

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Section: Resultsmentioning

confidence: 99%

Leveraging corona virus disease 2019 vaccination to promote hepatitis C screening

Vanderhoff

Smookler

Biondi

et al. 2022

Hepatology Communications

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“…Patients with severe mental illness, such as schizophrenia [65,66] and bipolar disorder [67] have been shown to have higher rates of HCV compared to the general population and thus, it may not be uncommon to treat patients with HCV who are already treated with antipsychotic medications for severe mental illness. Albeit rare, antipsychotic medications may be used to treat de novo secondary to IFNα [68-72].…”

Section: Resultsmentioning

confidence: 99%

Psychiatric treatment considerations with direct acting antivirals in hepatitis C

et al. 2013

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BackgroundDespite recent advances in hepatitis C (HCV) treatment, specifically the addition of direct acting antivirals (DAAs), pegylated interferon-alpha remains the backbone of HCV therapy. Therefore, the impact of DAAs on the management of co-morbid psychiatric illness and neuropsychiatric sequalae remains an ongoing concern during HCV therapy. This paper provides a review of the neuropsychiatric adverse effects of DAAs and drug-drug interactions (DDIs) between DAAs and psychiatric medications.MethodsWe conducted a Pubmed search using relevant search terms and hand searched reference lists of related review articles. In addition, we searched abstracts for major hepatology conferences and contacted respective pharmaceutical companies for additional studies.ResultsLimited data is available on the neuropsychiatric adverse effects of DAAs; however, data from major clinical trials suggest that DAAs have minimal neuropsychiatric risk. DAAs can potentially interact with a variety of psychotropic agents via cytochrome P450 and p-glycoprotein interactions. Triazolam, oral midazolam, St. John’s Wort, carbamazepine and pimozide, are contraindicated with DAAs. DDIs between DAAs and antidepressants, anxiolytics, hypnotics, mood stabilizers, antipsychotics and treatments for opioid dependence are summarized.ConclusionsAlthough DAAs do not add significant neuropsychiatric risk, the potential for DDIs is high. Consideration of DDIs is paramount to improving medication adherence and mitigating adverse effects during HCV therapy.

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“…A small study performed in Boston[ 26 ] identified eight patients with hepatitis C out of a total cohort of 98 patients (8.2%) treated with clozapine; one was a confirmed intravenous drug user, three had a history of polysubstance misuse and in the remaining four patients no risk factors were identified. A further small Canadian study[ 27 ] reported a hepatitis C rate of 2.7% (3/110) of clozapine-treated patients. Two of the three patients diagnosed with hepatitis C had a history of intravenous drug use.…”

Section: Chronic Liver Diseasementioning

confidence: 99%

Gastrointestinal and liver disease in patients with schizophrenia: A narrative review

Grant¹,

Brindle²,

Donnelly³

et al. 2022

World J Gastroenterol

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Schizophrenia is a severe mental illness which can have a devastating impact on an individual’s quality of life. Comorbidities are high amongst patients and life expectancy is approximately 15 years less than the general population. Despite the well-known increased mortality, little is known about the impact of gastrointestinal and liver disease on patients with schizophrenia. We aimed to review the literature and to make recommendations regarding future care. Literature searches were performed on PubMed to identify studies related to gastrointestinal and liver disease in patients with schizophrenia. High rates of chronic liver disease were reported, with Non-Alcoholic Fatty Liver Disease being of particular concern; antipsychotics and metabolic syndrome were contributing factors. Rates of acute liver failure were low but have been associated with antipsychotic use and paracetamol overdose. Coeliac disease has historically been linked to schizophrenia; however, recent research suggests that a causal link is yet to be proven. Evidence is emerging regarding the relationships between schizophrenia and peptic ulcer disease, inflammatory bowel disease and irritable bowel syndrome; clinical vigilance regarding these conditions should be high. Patients with schizophrenia poorly engage with bowel cancer screening programmes, leading to late diagnosis and increased mortality. Clozapine induced constipation is a significant issue for many patients and requires close monitoring. There is a significant burden of gastrointestinal and liver disease amongst patients with schizophrenia. Better levels of support from all members of the medical team are essential to ensure that appropriate, timely care is provided.

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Determining rates of hepatitis C in a clozapine treated cohort

Cited by 11 publications

References 29 publications

Leveraging corona virus disease 2019 vaccination to promote hepatitis C screening

Leveraging corona virus disease 2019 vaccination to promote hepatitis C screening

Psychiatric treatment considerations with direct acting antivirals in hepatitis C

Gastrointestinal and liver disease in patients with schizophrenia: A narrative review

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