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Direct‑acting antiviral treatment is safe and effective for chronic HCV patients with psychiatric disorders
Hiroshi Okano1, Takanori Takenaka1, Hiroki Asakawa1
1Department of Gastroenterology, Suzuka General Hospital, Suzuka, Mie 513-8630, Japan.
Insights
Direct-acting antiviral treatments are effective and safe for patients with hepatitis C virus (HCV) infection, including those with psychiatric disorders. These treatments offer significant benefits for all HCV patients, preventing severe liver disease.
Area of Science:
- Hepatology
- Psychiatry
- Pharmacology
Background:
- Hepatitis C virus (HCV) infection is treatable with direct-acting antivirals (DAAs).
- The efficacy and safety of DAAs in HCV patients with psychiatric disorders are not well-established.
- Psychiatric comorbidities may impact treatment outcomes in chronic HCV infection.
Purpose of the Study:
- To compare the efficacy and safety of DAA treatments in HCV patients with and without psychiatric disorders.
- To evaluate sustained virologic response (SVR) rates in these patient groups.
- To assess the tolerability of DAAs in psychiatric patients with HCV.
Main Methods:
- Retrospective, single-center observational study.
- Data collected from September 2014 to December 2021 at Suzuka General Hospital, Japan.
- Statistical analysis included Fisher's exact test, Mann-Whitney U test, and Friedman's test.
Main Results:
- 15 HCV patients with psychiatric disorders (P) and 209 without (NP) received DAA treatment.
- SVR rates were 80% in group P and 90% in group NP, with no significant difference.
- No significant differences in laboratory data or treatment-related adverse events were observed between groups.
Conclusions:
- DAA treatment is effective, safe, and well-tolerated in HCV patients with psychiatric disorders.
- Psychiatric patients with HCV should receive DAA treatment to prevent liver disease progression.
- DAAs offer comparable outcomes for HCV patients regardless of psychiatric status.
Abstract:
Although most patients with hepatitis C virus (HCV) infection have been cured since the introduction of direct-acting antiviral (DAA) treatments, whether patients with psychiatric disorders and chronic HCV infection receive benefits from DAA treatments remain unclear. The efficacy and safety of DAA treatment were compared between patients with and without psychiatric disorders. Data were retrospectively collected from medical records at the Suzuka General Hospital (Japan) between September 2014 and December 2021. The study was an observational, single-center study. Fisher's exact test, Mann-Whitney U test and Friedman's test were used for the comparisons between groups. Patients with HCV infection who had been started on DAA treatments were included. In total, 15 HCV cases with psychiatric disorders (P) and 209 HCV cases with nonpsychiatric disorders (NP) were started on DAA treatments for HCV infection. Patients in group P were younger (55±13.9 years) compared with those in group NP (68±13.0 years). A total of 12 patients (80%) in group P achieved and 188 patients (90%) in group NP achieved sustained virologic response (SVR), with no significant difference between the two groups. The remaining three patients in group P who did not achieve SVR included two drop-out cases. Regarding the laboratory data at the end of DAA treatments and SVR, there were no significant differences between the two groups. There were no cases of discontinuation or reduction of medication due to psychiatric disorders during DAA treatment. DAA treatment for HCV infection is effective, tolerable and safe for psychiatric patients, as well as patients without psychiatric disorders. Psychiatric patients with HCV infection should undergo DAA treatment to prevent progression to liver failure and/or cancer.
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