Interferon-based hepatitis C treatment in patients with pre-existing severe mental illness and substance use disorders

Abstract

Hepatitis C infection in patients with mental illness and drug addiction is highly prevalent and infrequently treated. Over the past 5 years, a wealth of studies specifically focused on these groups have demonstrated comparable rates of sustained virological response, compliance and adverse events. Optimization of psychotropic and opioid-replacement therapy with integrated psychiatric/addiction treatment prior to and during IFN-α initiation produces optimal results. Experience in treating these populations demonstrates clinical outcomes comparable with those without these comorbidities. Patients with mental illness and drug addiction should have routine screening and treatment for HCV infection to prevent associated morbidity and mortality.

Keywords::

• buprenorphine
• compliance
• depression
• drug addiction
• hepatitis C
• IFN-α
• methadone
• psychiatric
• substance abuse

Acknowledgements

We gratefully thank Kathleen Noonan for the performance of our literature search. We also acknowledge Muthoka Mutinga and Barbara McGovern for their helpful comments.

Financial disclosure

Kenneth Freedman has received research funding from Roche Pharmaceuticals and is on the Speaker’s Bureau for Schering-Plough. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.