Psychiatric behavioral aspects of comanagement of hepatitis C virus and HIV

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Jeffrey J Weiss1, Jack M Gorman

  • 1Department of Psychiatry, Mount Sinai School of Medicine,1160 Fifth Avenue, Box 1228, New York, NY 10029, USA. Jeffrey.Weiss@msnyuhealth.org

Current HIV/AIDS Reports
|October 13, 2006
PubMed

Insights

Treating hepatitis C virus (HCV) in HIV-positive patients is crucial, but side effects complicate care. Research is needed to predict treatment success and manage neuropsychiatric issues in coinfected individuals.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Psychiatry

Background:

  • Hepatitis C virus (HCV) coinfection accelerates liver disease progression in individuals with human immunodeficiency virus (HIV).
  • HCV coinfection is a leading cause of mortality in the HIV-positive population as HIV-related deaths decline.
  • Active treatment of HCV in coinfected patients is gaining importance.

Purpose of the Study:

  • To highlight the need for research into predictors of HCV treatment adherence and outcomes in coinfected patients.
  • To emphasize the necessity of identifying optimal psychiatric management strategies for HCV therapy-related neuropsychiatric effects.

Main Methods:

  • This study is a review of current challenges and future research directions regarding HCV treatment in coinfected patients.
  • It synthesizes existing knowledge on the impact of neuropsychiatric comorbidities on treatment outcomes.

Main Results:

  • Current HCV treatments (pegylated interferon and ribavirin) yield sustained viral response in only up to 40% of coinfected patients.
  • Neuropsychiatric side effects are common and providers are hesitant to initiate treatment due to high rates of psychiatric illness, cognitive impairment, and substance use disorders in this population.

Conclusions:

  • There is an urgent need for research to identify psychiatric and behavioral predictors of HCV treatment adherence and virologic outcomes.
  • Optimal psychiatric management strategies for neuropsychiatric sequelae of HCV therapy are essential for improving patient care.

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