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Depression and anxiety not barriers to HCV treatment success

Researchers have found that some people with chronic hepatitis C virus (HCV) in high-income countries also have mental health and substance use issues. At least two studies have found that people with HCV are more likely to have illnesses such as schizophrenia and bipolar disorder than the average person without HCV. It is possible that some people with HCV who also have undiagnosed, untreated or poorly managed mental health conditions may not be able to fully engage with their overall care and their treatment of HCV unless they get adequate support.

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To investigate the intersection of mental health, substance use and HCV treatment, researchers at several community health centres in San Diego undertook a study.

The researchers reviewed the clinics’ healthcare records and found the following:

  • 3,233 people had HCV infection
  • 369 people had already been treated for HCV
  • 65 people were currently taking HCV treatment

Among all 3,233 people with HCV, researchers stated that nearly 78% had a “mental health and/or substance abuse diagnosis.” The specific diagnoses were distributed as follows:

  • 28% had “only a substance abuse diagnosis”
  • 12% had “only mental health disorder”
  • 38% had “both diagnoses”

Among the 434 people who had taken or were currently taking HCV treatment, researchers found that 78% had “either a substance abuse, a mental health diagnosis or both.”

Specific diagnoses

Among all 3,233 people diagnosed with HCV infection, common additional diagnoses were as follows:

  • major depression – 17%
  • anxiety disorders – 11%
  • psychotic disorders – 5%
  • alcohol dependence – 6%
  • stimulant dependence – 6% (mostly to amphetamines)

Among the people who had taken or who were currently taking HCV treatment, the most common additional diagnoses were as follows:

  • major depression – 32%
  • anxiety disorders – 17%
  • “drug dependence in remission” – 13%
  • “alcohol dependence in remission” – 10%

Moving forward

According to the San Diego researchers, here were some key points from their study:

“Mental health and substance abuse issues are common in our urban, underserved, primary care–based HCV treatment program.”

The researchers said that having both “mental health and substance diagnoses” was not a barrier to successful HCV treatment.

The study team encouraged other care providers to identify these co-morbidities before HCV treatment is initiated or during HCV treatment. Once identified, the diagnosis of these co-morbidities could serve as an opportunity to offer services such as “case management, behavioural therapy, rehabilitation services and group therapy.” Such interventions could help improve success rates with HCV treatment and the overall health and quality of life of people struggling with mental health and addiction issues.

—Sean R. Hosein

REFERENCE:

Nateras A, Wallace D, Moreau M, et al. High prevalence of concomitant substance abuse and mental health disorders in an urban underserved FQHC-based HCV treatment program. In: Program and abstracts of the International Liver Congress, 19-23 April 2017, Amsterdam, the Netherlands. Poster 200.