Efficacy and safety of interferon-free regimens in patients affected by chronic hepatitis C and psychiatric disorders |
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| Affiliation: | 1. Department of Tropical Medicine, The Jikei University School of Medicine, Tokyo, Japan;2. Department of Infectious Diseases and Infection Control, The Jikei University School of Medicine, Tokyo, Japan;1. Departamento de Enfermedades Infecciosas, Hospital de Infectología, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;2. Departamento de Microbiología, Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, IPN, Mexico City, Mexico;3. Centro de Simulación Médica, Facultad Mexicana de Medicina, Universidad La Salle, Mexico City, Mexico;4. Laboratorio Central de Epidemiología, División de Laboratorios de Vigilancia e Investigación Epidemiológica, CMN “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;5. Unidad de Investigación en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;6. Departamento de Patología Clínica, Banco Central de Sangre, CMN “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;7. Laboratorio de Urgencias, Hospital de Infectología, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;8. Center for HIV and Hepatogastroenterology, Duesseldorf, Germany;1. Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan;2. Department of Emergency and Critical Care Center, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan;3. Hibiya Clinic, Tokyo, Japan;4. Department of Infectious Diseases, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan;1. Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, 001-0020, Japan;2. Department of Bacteriology II, National Institute of Infectious Diseases, Musashi-Murayama, Tokyo, 208-0011, Japan;3. Leprosy Research Center, National Institute of Infectious Diseases, Higashi-Murayama, Tokyo, 189-0002, Japan;4. The Global Station for Zoonosis Control, Hokkaido University Global Institution for Collaborative Research and Education, Sapporo, 001-0020, Japan;1. Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 1-1-1 Tsushima-naka, Kita-ku, Okayama, 7008530, Japan;2. Department of Pharmacy, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 7008558, Japan;3. Department of Pharmaceuticals Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 1-1-1 Tsushima-naka, Kita-ku, Okayama, 7008530, Japan;4. Education and Research Center for Clinical Pharmacy, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 1-1-1 Tsushima-naka, Kita-ku, Okayama, 7008530, Japan;5. Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama, 7008558, Japan;1. Internal Medicine, National Hospital Organization Nishi-Beppu Hospital, 4548 Tsurumi, Beppu, Oita, 874-0840, Japan;2. Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan;3. Graduate School of Public Health, St. Luke''s International University, OMURA Susumu & Mieko Memorial St. Luke''s Center for Clinical Academia, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan |
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| Abstract: | The presence of psychiatric disorders (PD) in patients affected by chronic hepatitis C (CHC) was a major contraindication for the treatment with interferon (IFN)-based regimens. The novel IFN-free approach using the direct-acting antiviral agents (DAAs) is an interesting and promising chance for these subjects. In this retrospective analysis we focused the attention on the virological response and safety of CHC patients affected by PD and treated with IFN-free regimens.136 subjects were enrolled in this study. Treatment naïve were 78 (57.3), experienced 58 (42.6%). Major depression was present in 25 patients (18.4%), anxiety disorders in 37 (27.2%), bipolar disorders in 23 (16.9%), schizophrenia in 17 (12.5%), behavioral disturbance in 21 (15.4%), psychosis in 13 (9.5%). Psychoactive medication taken by patients were: benzodiazepines (n = 29, 21.3%), antidepressants (n = 24, 17.6%), neuroleptics (n = 29, 21.3%), mood stabilizers (n = 19, 14%), combinations of different drugs (n = 17, 12.5%). Sustained virological response at 12 weeks of follow-up (SVR12) was observed in 128 patients (94.1%), drop-out were 3 (2.2%). No adverse events or significant drug-related side-effects were reported.The treatment with novel IFN-free therapies against CHC were higher effective and well tolerated also in patients with PD taking psychoactive medications. |
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| Keywords: | Chronic hepatitis C Psychiatric disorders Virological response Safety Psychotropic medications Interferon-free |
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