Mental disorders in HIV/HCV coinfected patients under antiviral treatment for hepatitis C

Martin-Subero, Marta; Díez‐Quevedo, Crisanto

doi:10.1016/j.psychres.2016.09.041

Cited by 7 publications

(6 citation statements)

References 86 publications

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“…Additionally, HCV treatment in co-infection is not as straightforward as in HCV mono-infection due to potential drug-drug interactions (Chen & Jain, 2015). Accordingly, a routine screening of depression in co-infected patients would still be critical to a prompt diagnosis and adequate planning of antidepressant treatment during HCV therapy, which has been however considered safe (Martin-Subero, & Diez-Quevedo, 2016). This systematic review is not without limitations.…”

Section: Discussionmentioning

confidence: 99%

Depression in HIV and HCV co-infected patients: a systematic review and meta-analysis

Fialho

Pereira

Rusted

et al. 2017

Psychology, Health & Medicine

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The aim of this study was to carry out a systematic review and meta-analysis of the differences in the prevalence of depression and presence of depressive symptoms between HIV/HCV co-infection, HIV mono-infection, and hepatitis C virus (HCV) mono-infection. A systematic electronic search of bibliographic databases was performed to locate articles published from the earliest available online until December 2014. Outcomes of depression were based on clinical interviews and validated self-reported measures of depression/depressive symptoms. Of the 188 records initially screened, 29 articles were included in the descriptive systematic review and six were included in the meta-analysis. The meta-analytic results indicated that, as measured by self-reported measures of depression, HIV/HCV co-infected patients were significantly more likely to report depressive symptoms than either HIV (SMD = .24, 95% CI: .03-.46, p = .02) or HCV mono-infected (SMD = .55, 95% CI: .17-.94, p = .005) patients. The variability of the results of the reviewed studies, largely dependent on the samples' characteristics and the methods of assessment of depression, suggests that a clear interpretation of how depression outcomes are affected by the presence of HIV/HCV co-infection is still needed. Failing to diagnose depression or to early screen depressive symptoms may have a significant impact on patients' overall functioning and compromise treatments' outcomes.

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Section: Discussionmentioning

confidence: 99%

Depression in HIV and HCV co-infected patients: a systematic review and meta-analysis

Fialho

Pereira

Rusted

et al. 2017

Psychology, Health & Medicine

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“…Interferon elimination also removed its potential exacerbation of mental health conditions that are frequent co-occurrences among persons with substance use disorders, which could reduce treatment adherence and might be reasons for treatment failure 43,44. Shorter treatment duration, 2 to 3 months as opposed to 6 or 11 months, is also a potential benefit of direct-acting antivirals that can increase treatment adherence among persons with substance use disorders.…”

Section: Evolution Of Hepatitis C Virus Treatmentmentioning

confidence: 99%

Medical and Behavioral Approaches to Engage People Who Inject Drugs Into Care for Hepatitis C Virus Infection

Gonzalez¹,

Fierer

Talal

2017

Addictive Disorders &Amp; Their Treatment

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Direct-acting antivirals for hepatitis C virus infection may revolutionize treatment among persons with substance use disorders. Despite persons with substance use disorders having the highest hepatitis C virus prevalence and incidence, the vast majority have not engaged into care for the infection. Previously, interferon-based treatments, with substantial side effects and the propensity to exacerbate mental health conditions, were major disincentives to pursuit of care for the infection. Direct-acting antivirals with viral eradication rates of >90%, significantly improved side effect profiles, and shorter treatment duration are dramatic improvements over prior treatment regimens that should promote widespread hepatitis C virus care among persons with substance use disorders. The major unmet need is strategies to promote persons with substance use disorders engagement into care for hepatitis C virus. Although physical integration of treatment for substance use and co-occurring conditions has been widely advocated, it has been difficult to achieve. Telemedicine offers an opportunity for virtual integration of behavioral and medical treatments that could be supplemented by conventional interventions such as hepatitis C virus education, case management, and peer navigation. Furthermore, harm reduction and strategies to reduce viral transmission are important to cease reinfection among persons with substance use disorders. Widespread prescription of therapy for hepatitis C virus infection to substance users will be required to achieve the ultimate goal of global virus elimination. Combinations of medical and behavioral interventions should be used to promote persons with substance use disorders engagement into and adherence with direct-acting antiviral-based treatment approaches. Ultimately, either physical or virtual colocation of hepatitis C virus and substance use treatment has the potential to improve adherence and consequently treatment efficacy.

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“…Several factors can affect the prevalence of HCV, such as the area of residence, age, sex, race, or comorbidities 2‐5 . Several epidemiological studies have analyzed the presence of HCV in patients with psychiatric illnesses (schizophrenia, bipolar disorder, substance use disorder, etc), evidencing a higher prevalence than in the general population 6‐9 . On the other hand, in parallel with liver disease, HCV can cause extrahepatic manifestations, among which are neurological and psychiatric diseases 10‐13 .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of direct‐acting antivirals in hepatitis C infected patients with mental disorders: Results in real clinical practice

Margusino‐Framiñán

Bobadilla‐Pérez

Cid‐Silva

et al. 2020

Journal of Medical Virology

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The aim of this study is to analyze the effectiveness and safety of direct‐acting antivirals (DAAs) in psychiatric patients with chronic hepatitis C (CHC). Secondary objectives included adherence and drug‐drug interaction (DDIs) evaluations. Prospective observational comparative study carried out during 3 years. Psychiatric patients were included and mental illness classified by a psychiatric team based on clinical records. Main effectiveness and safety variables were sustained virologic response (SVR) at posttreatment week 12 (SVR12) and rate of on‐treatment serious drug‐related adverse events (AEs), respectively. A total of 242 psychiatric and 900 nonpsychiatric patients were included. SVR12 by intention‐to‐treat (ITT) analysis of psychiatric vs nonpsychiatric patients was 92.6% (95% confidence interval [CI], 89.1‐96.1) vs 96.2% (95% CI, 94.9‐97.5) (P = .02). SVR12 by modified‐ITT analysis was 97.8% (95% CI, 95.0‐99.3) vs 98.4% (95% CI, 97.5‐99.3) (P = .74). 92.2% of psychiatric patients with mental disorders secondary to multiple drug use (MDSDU) and 93.0% of psychiatric patients without MDSDU vs 96.2% of nonpsychiatric patients reached SVR12 (P = .05 and P = .20, respectively). The percentage of adherent patients to DAAs did not show differences between cohorts (P = .08). 30.2% of psychiatric patients and 27.6% of nonpsychiatric patients presented clinically relevant DDIs (P = .47). 1.7% vs 0.8% of psychiatric vs nonpsychiatric patients developed serious AEs (P = .39); no serious psychiatric AEs were present. DAAs have shown a slightly lower effectiveness in psychiatric patients with CHC, as a result of loss of follow up, which justifies the need for integrated and multidisciplinary health care teams. DAAs safety, adherence, and DDIs, however, are similar to that of nonpsychiatric patients.

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Mental disorders in HIV/HCV coinfected patients under antiviral treatment for hepatitis C

Cited by 7 publications

References 86 publications

Depression in HIV and HCV co-infected patients: a systematic review and meta-analysis

Depression in HIV and HCV co-infected patients: a systematic review and meta-analysis

Medical and Behavioral Approaches to Engage People Who Inject Drugs Into Care for Hepatitis C Virus Infection

Effectiveness and safety of direct‐acting antivirals in hepatitis C infected patients with mental disorders: Results in real clinical practice

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