Psychiatric and substance use disorders co-morbidities and hepatitis C: Diagnostic and treatment implications

Table 4 Antiviral treatment response rates in patients with psychiatric and substance use disorders comorbidities

Ref.	n	Design	Treatment	Outcomes
Dalgard et al[31]	27	Longitudinal assessment	IFN-α-2a	Rate of reinfection was not significantly different among IVDUers treated for HCV as compared to non IVDUers despite reinitiation of injection drug use in 33% of IVDUers
Loftis et al[27]	39	Prospective cohort study	IFN-α-2b/RBV	Gender, past history of MDD, and past history of SUD were not significantly associated with response rates
Backmund et al[47]	18	Longitudinal assessment	IFN-α-2a, IFN-α-2a/RBV	IVDUers can be reinfected after treatment for HCV infection, but the reinfection rate is minimal and should not jeopardize the potential benefit for most patients
Chainuvati et al[40]	647	Retrospective database review	Eligibility/treatment rates for Interferon therapy	Therapy completion and SVR rates are similar among Veterans with and without psychiatric or SUDs, challenging the perception that adherence is worse as a result of psychiatric co-morbidities
Anand et al[42]	4061	Longitudinal assessment	IFN-α-2b/RBV	Patients with and without mild to moderate alcohol use had comparable completion and SVR rates to antiviral treatment
Hauser et al[38]	55	Retrospective chart review	PEGIFN/RBV, IFN/RBV	People with MDD had completion and SVR rates similar to those without psychiatric illness. Patients with MDD can be safely and effectively treated with antiviral therapy provided that they are on antidepressant medications during antiviral therapy
Huckans et al[43]	60	Retrospective chart review	PEGINF/RBV, IFN/RBV	Patients with schizophrenia experience similar rates of psychiatric symptoms on and off antiviral therapy
Grebely et al[48]	58	Prospective longitudinal follow up	IFN-α-2b/RBV, PEGIFN-α-2a, PEGIFN-α-2b	Rate of reinfection following treatment for HCV infection among current and former IVDUers engaged in a multidisciplinary program is low

IFN-α: Interferon alpha; IVDUer: Intravenous drug user; RBV: Ribavirin; MDD: Major depressive disorder; SUD: Substance use disorder; SVR: Sustained virologic response; PEGINF: Peglyated interferon (peginterferon); IFN: Interferon.