Schizophrenia Bulletin Advance Access published online on June 17, 2008
Schizophrenia Bulletin, doi:10.1093/schbul/sbn065
Antiviral Therapy Completion and Response Rates Among Hepatitis C Patients With and Without Schizophrenia
2 Northwest Hepatitis C Resource Center
3 Behavioral Health and Clinical Neurosciences Division, Portland VA Medical Center
4 Department of Psychiatry, Oregon Health and Science University, Portland, Oregon
5 Department of Behavioral Neurosciences, Oregon Health and Science University, Portland, Oregon
6 The J.E.N.S. Laboratory, Portland VA Medical Center
7 Department of Internal Medicine, Oregon Health and Science University, Portland 97239, Oregon
1 To whom correspondence should be addressed; Portland VA Medical Center (P3MHDC), 3710 Southwest US Veterans Hospital Road, Portland 97239, OR; tel: 503-220-8262 ext. 54689; fax: 503-220-3499; e-mail: marilyn.huckans{at}va.gov.
Background: Despite disproportionately high rates of hepatitis C (HCV) among patients with severe mental illness, to date, there is scant empirical data available regarding antiviral therapy outcomes within this population. Objective: To compare antiviral therapy completion and response rates between HCV patients with vs those without schizophrenia (SCHZ). Methods: A regional Veterans Healthcare Administration database was used to identify veterans meeting criteria for this retrospective chart review. All patients confirmed to have SCHZ and to have received antiviral therapy between 1998 and 2006 (n = 30) were compared with a control group of demographically matched (HCV genotype, age, race, gender) patients with no history of SCHZ (n = 30). Results: For HCV patients with genotype 1, antiviral completion, end of treatment response (ETR), and sustained viral response (SVR) rates did not significantly differ between groups. For those with genotypes 2 and 3 combined, antiviral therapy completion rates did not significantly differ between groups; however, the SCHZ group was significantly (P < 0.050) more likely to achieve an ETR and an SVR. For all genotypes combined, the SCHZ patients were no more likely than controls to discontinue therapy early for psychiatric symptoms, medical complications, or other adverse events, and groups did not significantly differ in terms of hospitalization rates during antiviral therapy. Conclusion: Our retrospective chart review suggests that patients with SCHZ complete and respond to antiviral therapy for HCV at rates comparable with those without SCHZ. Based on these data, SCHZ should not be considered a contraindication to antiviral therapy for HCV.
Keywords: interferon / mental disorders / psychotic disorders / adverse effects