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HCV eradication in veterans with underlying mental health disorders and substance use

Amanda P Ifeachor, Kelly K Houck, Samantha Schulte

    Journal of the American Pharmacists Association : Japha
    |September 19, 2020
    PubMed

    Insights

    Hepatitis C treatment with direct-acting antivirals (DAAs) achieves high sustained virologic response (SVR) rates. These high SVR rates were observed in patients with mental health disorders or substance use, similar to those without these conditions.

    Area of Science:

    • Hepatology
    • Infectious Diseases
    • Psychiatry

    Background:

    • Hepatitis C virus (HCV) disproportionately impacts individuals with mental health disorders and substance use.
    • Opioid epidemic drives increasing HCV transmission in the US.
    • Limited historical access to HCV treatment for patients with mental health and/or substance use disorders.

    Purpose of the Study:

    • Compare sustained virologic response (SVR) rates of direct-acting antiviral (DAA) therapy for Hepatitis C virus (HCV).
    • Evaluate treatment outcomes between patients with and without mental health disorders, substance use, or a combination of both.

    Main Methods:

    • Retrospective chart review of 833 patients completing DAA treatment at a Veterans Affairs medical center (August 2013 - August 2017).
    • Patients categorized into two groups: those with mental health/substance use disorders and those without.
    • Collected data on baseline variables, DAA regimen, patient engagement efforts, and SVR rates.

    Main Results:

    • 579 out of 833 patients had at least one mental health disorder, substance use, or both.
    • Most prevalent conditions included substance use (n=333), substance-related disorders (n=176), and depressive disorders (n=159).
    • No statistically significant difference in SVR rates or patient engagement efforts between groups.

    Conclusions:

    • Direct-acting antiviral (DAA) therapy demonstrates high efficacy for Hepatitis C virus (HCV) treatment.
    • Sustained virologic response (SVR) rates exceeded 95% across the entire cohort.
    • DAA treatment is effective in patients with or without mental health disorders or substance use.
    Abstract

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