How Does Mental Illness Impact Hepatitis C Adherence?

A recent study found that sofosbuvir-based therapy is safe to treat patients with hepatitis C virus (HCV) who also have mental health disease (MHD), and that there may even be benefits, although it is unclear how long the benefits may last.

The study was published in the World Journal of Hepatology as an article in press on September 8, 2016, and was conducted by Lydia Shuk Yee Tang, MD, of the Institute of Human Virology in the Division of Infectious Diseases at the University of Maryland School of Medicine, and colleagues.

The aim of the study, say the authors, was “to study impact of baseline mental health disease on hepatitis C virus treatment; and Beck’s Depression Inventory (BDI) changes with sofosbuvir- and interferon-based therapy.”

In order to investigate, the researchers conducted a retrospective cohort study, and examined the data collected on participants in 5 other studies. Those participants all had some form of MHD, including major depression, bipolar disorder, schizophrenia, generalized anxiety, post-traumatic stress disorder, or a prescription of antidepressants, antipsychotics, mood stabilizers, or psychotropics.

The researchers report, “Sofosbuvir-based therapy was equally effective among participants with MHD, and among those without MHD.” Additionally, patients with MHD showed similar levels of adherence and had similar sustained virologic response (SVR) as those without MHD.

“Furthermore, among participants with HIV/HCV coinfection treated with DAA therapy, we observed a statistically significant improvement in BDI scores during and after the end of treatment point (post-treatment) compared to baseline (pre-treatment), while participants treated with IFN-based therapy saw no significant change in BDI scores,” say the researchers.

The researchers hope that this study is a door-opener, and say they hope “these preliminary findings will open the dialogue to further expand eligibility to those with MHD and lead to further, larger studies involving patients with more challenging characteristics: Not just those with baseline MHD, but also those with substance abuse -- two diagnoses which are frequently paired.”