Hepatitis C treatment completion in individuals with psychiatric comorbidity and depression

Area of Science:

• Hepatology
• Infectious Diseases
• Primary Care Medicine

Background:

• Hepatitis C virus (HCV) is a prevalent bloodborne pathogen.
• Access to HCV treatment is limited by patient, provider, and system factors, resulting in low initiation and continuation rates.
• Behavioral health comorbidities are common in HCV patients and have historically been a barrier to treatment.

Purpose of the Study:

• To implement and evaluate an interdisciplinary, nurse-managed primary care program for Hepatitis C evaluation and treatment.
• To concurrently address behavioral health needs in HCV patients to improve treatment initiation and continuation.
• To determine if behavioral health history or new-onset mood disorders impact treatment discontinuation.

Main Methods:

• An interdisciplinary, nurse-managed primary care program was implemented for HCV evaluation and treatment.
• Behavioral health needs were addressed concurrently within the primary care setting.
• Treatment discontinuation rates were analyzed in relation to psychiatric or substance use history and mood changes during treatment.

Main Results:

• No association was found between a history of psychiatric or substance use disorders and treatment discontinuation.
• No association was found between developing depression or anxiety during treatment and treatment discontinuation.
• Concurrent management of behavioral health needs did not negatively impact treatment continuation.

Conclusions:

• Addressing behavioral health comorbidities concurrently with Hepatitis C evaluation and treatment can improve treatment continuation rates.
• Integrated care models in primary care settings can effectively remove barriers to chronic Hepatitis C treatment.
• This approach supports increased treatment completion for patients with Hepatitis C virus and co-occurring behavioral health conditions.