Mental disorders in HIV/HCV coinfected patients under antiviral treatment for hepatitis C

• Published in: Psychiatry research Vol. 246; pp. 173 - 181
• Main Authors: Martin-Subero, Marta, Diez-Quevedo, Crisanto
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 30-12-2016
• Subjects: Antiretroviral Therapy, Highly Active; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Coinfection; Coinfection - drug therapy; Direct-acting Antivirals; Disease Management; Hepatitis C; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; HIV; HIV Infections - complications; HIV Infections - drug therapy; Humans; Interferon-alpha; Interferon-alpha - adverse effects; Mental disorders; Mental Disorders - chemically induced; Mental Disorders - complications; Mental Disorders - therapy; Psychiatry; Coinfection; HIV; Mental disorders; Hepatitis C; Interferon-alpha; Direct-acting Antivirals
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2016.09.041

Abstract This paper aims to review the epidemiology and management of mental disorders in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients, the need for antiviral therapy in this specific population, and current treatment strategies for HIV/HCV patients with psychiatric and/or substance use disorders. This is a narrative review. Data was sourced from electronic databases and was not limited by language or date of publication. HIV infection has become a survivable chronic illness. Prevalence of HCV infection among HIV-infected patients is high ranging from 50% to 90%. Patients with psychiatric diseases have also an increased risk for HIV/HCV coinfection. The most effective strategy to decrease HCV-related morbidity and mortality in coinfection is to achieve viral eradication. Although psychiatric symptoms often appear during antiviral treatment and may be associated with the use of interferon-alpha (IFN-α), recent evidence suggests that many patients with comorbid mental and substance use disorders can be treated safely. Recent data indicate that IFNα-induced psychiatric side effects have a similar prevalence in HIV/HCV coinfected patients than in monoinfected patients and they can be managed and even prevented successfully with psychopharmacological strategies in the frame of a multidisciplinary team. New antivirals offer INF-free therapies for this specific population.