Time to rethink antiviral treatment for hepatitis C in patients with coexisting mental health/substance abuse issues
Open accessAbstract
Background A new era has dawned in the treatment of chronic hepatitis C (HCV) virus with the use of direct-acting antiviral medications augmenting combination therapy. Unfortunately, the significant impact of improvements may not be realized if antiviral treatment is not expanded to include a larger proportion of patients, many of whom have coexisting mental health and/or substance abuse issues and have been historically deferred from treatment.Methods We reviewed the extent literature on HCV treatment for individuals with co-occurring mental health and/or substance abuse issues.Results A number of empirically-based arguments exist in favor of treating HCV-infected individuals with mental health and/or substance abuse issues within the context of multidisciplinary team approaches. Integrated, collaborative, or hybrid models of care are just a few examples of multidisciplinary approaches that can combine the care of HCV treating providers with mental health and/or addictions providers to safely and effectively treat these patients. Collectively, these arguments and the empirical evidence that supports them, provides a strong rationale for why expanding antiviral therapy to these patients is critical and timely.Conclusions A decade of evidence suggests that HCV-infected individuals with mental health and/or substance abuse issues can safely and effectively undergo antiviral treatment when delivered through multidisciplinary care settings. Multidisciplinary approaches that combine HCV treating providers with mental health, addictions, and other support systems can facilitate preparation and successful treatment of these patients on antiviral therapy.
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The American Hospital Association recommends that behavioral health services be integrated throughout the health care delivery system.
“The American Hospital Association recommends that behavioral health services be integrated throughout the health care delivery system.3”
From A Behavioral Health Program for Alcohol Use Disorder, Substance Abuse, and Depression in Chronic Liver Disease (2019) · cites this paper as [3]
The “Build a Multidisciplinary Team” section advocates integrating mental health and substance-abuse services into HCV care. It does not attribute a recommendation to the American Hospital Association or call for integration throughout the health care delivery system; the recommendation it names is from a U.S. Department of Health and Human Services action plan. Page numbers were not available in our copy. (LLM, conf=0.83)
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- Authors
- Bonner, J. E., Barritt, A. S., Fried, M. W., & Evon, D. M.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Evon, Donna M.
- Venue
- Digestive Diseases and Sciences
- Published
- 2012-04-07
- Volume
- 57
- Issue
- 6
- Pages
- 1469-1474
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- PMC
- PMC3683978
- OpenAlex
- W2095422180
- Cited by
- 32
- References
- 52
- Citations by year
- 2024: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 8 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 6 · 2012: 1
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Vertex Pharmaceuticals
- National Institutes of Health (KL2TR001109)
- Genentech
- National Institute of Allergy and Infectious Diseases (P30AI050410)
- National Institute of Diabetes and Digestive and Kidney Diseases (L30 DK084885, K24DK066144, K23DK089004)
- National Center for Research Resources (1KL2-RR025746-03, KL2RR025746, UL1RR025747)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- chronic hepatitis C, direct-acting antivirals, co-occurring mental health disorders, substance use disorders, multidisciplinary care, integrated care model, barriers to treatment, treatment safety
- MeSH terms
- Antiviral Agents, Mental Disorders, Decision Making, Female, Humans, Male, Mental Health, Patient Compliance, Patient Education as Topic, United States, Comorbidity, Mental Competency, Risk Assessment, Hepatitis C, Chronic, Substance-Related Disorders, Needs Assessment
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