Hepatitis C virus infection is more frequent in veterans than in nonveterans.
Up to 85% of Hepatitis C-infected veterans have psychiatric and/or substance use co-morbidities.
Prior to the 2002 National Institute of Health Consensus Conference, the co-morbidities included relative contraindications to antiviral therapy, assuming a poor adherence.
Dr Garcia-Tsao and colleagues compared eligibility, completion and response to antiviral therapy in Hepatitis C-infected veterans with and without these comorbidities.
Veterans who were anti-Hepatitis C-positive and had been seen at least once in a liver clinic between 1999 and 2002 were identified.
Records were reviewed for patient demographics and status of liver disease.
The team also assessed treatment eligibility, type of therapy, completion of therapy and virological response.
|Sustained virological response did not differ significantly between groups|
|Journal of Viral Hepatitis|
The research team compared patients with active mental illness or substance abuse with those without these comorbidities.
Of 697 anti-Hepatitis C-positive-patients, 647 Hepatitis C-RNA-positive patients were included.
Of these, 294 had mental illness or substance abuse and 353 controls.
The team reported that patient demographics, viral and liver disease characteristics were comparable between groups.
Patients with mental illness or substance abuse were considered ineligible for therapy more frequently and were treated less frequently than controls.
However, the team noted that completion of therapy and sustained virological response did not differ significantly between groups.
Hepatitis C-infected veterans with mental illness or substance abuse are being offered therapy and treated less often than those without such co-morbidities.
However, the researchers noted that therapy completion and sustained virological response rates are similar.
Dr Garcia-Tsao's team commented, “These findings challenges the perception that adherence is poorer in this patient population.”