Clinical experience suggests that preexisting psychiatric conditions may adversely affect the ability to tolerate combination antiviral therapy in Hepatitis C.
Dr Adrian Dollarhide and colleagues from California evaluated the impact of common psychiatric disorders on completion of antiviral therapy in Hepatitis C virus positive US veterans.
The team performed a retrospective chart review of 130 Hepatitis C virus positive veterans treated with combination antiviral therapy from 2000 to 2004.
The combination treatment included interferon with ribavirin.
The research team examined baseline psychiatric, substance use, demographic, and comorbid medical disease variables for all patients started on treatment.
The researchers found that 13% of patients required treatment discontinuation for neuropsychiatric adverse effects.
|A body weight of 100kg or more predicted the likelihood of treatment completion|
|Journal of Clinical Gastroenterology|
There was no association between treatment completion, and any specific psychiatric diagnosis, or combined psychiatric and substance use diagnoses.
The team noted that there was no association between treatment completion, baseline use of antidepressants, and history of substance abuse/dependence.
The researchers observed no association between completing treatment and patients receiving either standard or pegylated interferon plus ribavirin therapies.
Psychiatric and substance use disorders were not associated with dropout due to neuropsychiatric adverse effects.
The team noted that baseline comorbid medical disorders also did not predict treatment completion.
However, higher body weight did predict likelihood of treatment completion.
The researchers observed this association especially for those weighing 100 kg or more compared with subjects weighing less than that.
Dr Dollarhide‘s team commented, “In this cohort of veterans, prior psychiatric or substance use history did not predict completion of recommended interferon with ribavirin treatment.”
“These findings suggest that a larger pool of veterans with psychiatric or substance use disorders may be considered candidates for antiviral therapy when provided with multidisciplinary support.”