Hepatitis C infection, antiviral treatment and mental health: a European expert consensus statement.
Journal of Hepatology. 2012-12-01; 57(6): 1379-1390
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1. J Hepatol. 2012 Dec;57(6):1379-90. doi: 10.1016/j.jhep.2012.07.037. Epub 2012 Aug
Hepatitis C infection, antiviral treatment and mental health: a European expert
Schaefer M(1), Capuron L, Friebe A, Diez-Quevedo C, Robaeys G, Neri S, Foster GR,
Kautz A, Forton D, Pariante CM.
(1)Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin
Berlin, Campus Charité Mitte, Berlin, Germany.
Mental health problems frequently occur in chronic infection with the hepatitis C
virus (HCV) and during antiviral treatment with pegylated interferon-alpha
(PegIFNα) and ribavirin. Depression is one of the most important complications
during antiviral treatment of chronic hepatitis C infection. However, an
increased prevalence of depression, fatigue, and cognitive disturbances has also
been reported in untreated HCV-positive patients. Patients with psychiatric
disorders or drug addiction also have an increased risk of HCV infection.
Furthermore, because of possible drug-drug interactions, new antivirals
administered together with PegIFNα and ribavirin may complicate psychiatric side
effect management, even if no specific psychiatric adverse events are known so
far for these new drugs. The European liver patient’s organization (ELPA)
organised a European expert conference to review the literature and develop
expert recommendations for the management of mental health problems in HCV
infected patients. This paper results from the output of the 2011 EASL meeting
and subsequent dialogue with patient groups and relevant experts in Europe. It
summarises the current knowledge of HCV infection and the brain; prevalence,
course, and neurobiology of IFN-α associated psychiatric side effects; possible
risk factors for IFN-α associated depression and suicide attempts; psychiatric
management of HCV infected patients before and during antiviral treatment;
prevention of IFN- α associated psychiatric side effects; and psychiatric aspects
of the new antivirals. The summarised current knowledge about mental health
changes before and during antiviral treatment should improve interdisciplinary
management of HCV infected patients.
Copyright © 2012. Published by Elsevier B.V. All rights reserved.
PMID: 22878466 [Indexed for MEDLINE]