Treatments for chronic hepatitis C infection using novel interferon (IFN)-free therapies were both highly effective and well tolerated in patients with psychiatric disorders who were taking psychoactive medications,  according to data published in the Journal of Infection and Chemotherapy

The presence of psychiatric disorders in patients with chronic hepatitis C has been a major contraindication for treatment with IFN-based regimens. In this study, the novel IFN-free approach using the direct-acting antiviral agents was evaluated.

A total of 136 patients were enrolled; 78 were treatment-naive and 58 were treatment-experienced. Patients presented with a variety of psychiatric disorders, including 25 with major depression, 37 with anxiety disorders, 23 with bipolar disorders, 17 with schizophrenia, 21 showing behavioral disturbance, and 13 with psychosis. The medications being taken by these individuals included benzodiazepines (n=29, 21.3%), antidepressants (n=24, 17.6%), neuroleptics (n=29, 21.3%), mood stabilizers (n=19, 14%), or combinations of different drugs (n=7, 12.5%).

After 12-weeks of follow-up, sustained virologic response was observed in 128 patients (94.1%) and there were 3 study dropouts (2.2%). There were no reports of adverse events or significant drug-related adverse events.


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The investigators did note several study limitations, including that the study design was retrospective. Second, the focus of the study was virologic response and treatment adherence during a short-term follow-up period and thus no data was collected regarding possible improvements in either the psychiatric disorder or chronic hepatitis. Further work is required to understand the role of hepatitis C viral eradication in psychiatric comorbidities.

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The results did show that treatment for chronic hepatitis C with novel IFN-free therapies is both effective and well tolerated in this subgroup of patients with psychiatric disorders who are taking psychoactive medications. 

Reference

Boglione L, Lupia T, Cariti G, Di Perri G. Efficacy and safety of interferon-free regimens in patients affected by chronic hepatitis C and psychiatric disorders. J Infect Chemother. 2020;26:18-22.