Background Treatment of hepatitis C virus (HCV) infection with pegylated interferon and ribavirin may induce psychiatric disorders, which may result in poor adherence and response to antiviral treatment.
Purpose We aimed to describe the incidence of neuropsychiatric disorders in a cohort of HCV-infected patients treated with interferon and ribavirin, and their impact on treatment adherence and viral response rate (SVR).
Materials and Methods Data from a cohort of HCV patients who visited an outpatient pharmacy service (OPS) included all adult patients mono-infected with HCV who had completed treatment in 2010. Monitoring of neuropsychiatric disorders was assessed at weeks 0, 4, 12, 24, 48, and 72 through the self-administered questionnaires Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (Goldberg). Adherence to treatment was assessed by counting drugs dispensed and patient reporting. Virological response was determined by the physician according to standard criteria.
Results Of the 76 patients included, 19 (25%) had a pre-existing psychiatric disorder, mostly depression and anxiety. The incidence of medically-confirmed neuropsychiatric disorders was 33% (n = 25), with a peak of abnormal results in the tests in week 12. Patients with and without pathological scores did not differ in baseline characteristics, except for pre-existing psychiatric disorder [60.0% vs. 7.8%, respectively (p < 0.001). Antidepressants and/or anxiolytics were prescribed to 48% of patients with medically confirmed disorders (n = 12). Overall, 43% of patients achieved an SVR. Strict adherence (96% vs. 90%; p = NS) and SVR (39% vs. 52%; p = NS) were similar in patients with or without medically confirmed disorders.
Conclusions Patients often develop neuropsychiatric disorders during interferon therapy. Neuropsychiatric side effects had a non-significant effect on adherence to treatment and attainment of SVR. Multidisciplinary monitoring provided during the treatment of hepatitis C can contribute to early detection and management of neuropsychiatric disorders and to improve integrated patient care.
No conflict of interest.
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