Psychiatric and Substance Use Disorders in Individuals with Hepatitis C: Epidemiology and Management
Abstract
Hepatitis C virus (HCV) infection is a major health concern in the US as well as in other countries worldwide. Treatment issues and disease management strategies are complicated by the extremely high rate of psychiatric and substance use disorders in those who have HCV. The majority of new and existing cases of HCV are related to injection drug use and, in this population, the prevalence of psychiatric comorbidity is high. Optimally, all patients with HCV should be screened for psychiatric and substance use disorders before initiation of antiviral therapy. If a patient screens positive, he or she should be referred to a mental healthcare provider or addiction specialist, assessed for the presence of a psychiatric or substance use disorder, and appropriately treated prior to initiation of antiviral (i.e. interferon) therapy. Although interferon-based therapies can lead to severe neuropsychiatric adverse effects, including in rare instances suicide, evidence suggests that many patients with comorbid psychiatric and substance use diagnoses can be treated safely and effectively using comanagement strategies. However, most patients with HCV are not treated with antiviral therapy. Therefore, we must expand our definition of HCV 'treatment' to include treatment of the comorbid psychiatric and substance use disorders that accompany HCV infection and precede antiviral therapy. This paper reviews the epidemiology and management of psychiatric and substance use disorders in patients with HCV, the issue of psychiatric and substance use disorders as contraindications for antiviral therapy, and current treatment strategies for HCV patients with these comorbid conditions.
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The most common transmission routes for hepatitis in persons with SMI are drug-use behaviors and sexual behaviors related to drug use.
“The most common transmission routes for persons with SMI are drug-use behaviors and sexual behaviors related to drug use (404-406).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [404]
Overall, an estimated 20-25% of persons with SMI are infected with hepatitis C virus.
“Overall, an estimated 20-25% of persons with SMI are infected with hepatitis C virus (360,404-407).”
From Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care (2011) · cites this paper as [404]
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DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
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Substance use disorders: Psychoneuroimmunological mechanisms and new targets for therapy
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Self-citation
- Authors
- Loftis, J. M., Matthews, A. M., & Hauser, P.
- Affiliations
- Oregon Health & Science University (US)
- ORCID
- Loftis, Jennifer M
- Venue
- Drugs
- Published
- 2006
- Volume
- 66
- Issue
- 2
- Pages
- 155-174
- ISSN
- 0012-6667 (ISSN-L)
- OpenAlex
- W2023562655
- Cited by
- 86
- References
- 150
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 3 · 2016: 6 · 2015: 6 · 2014: 9 · 2013: 9 · 2012: 6
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- hepatitis C, psychiatric comorbidity, substance use disorders, intravenous drug use, antiviral therapy, interferon adverse effects, neuropsychiatric adverse effects, suicide, mental health screening, addiction treatment, co-management, treatment contraindications
- MeSH terms
- Antiviral Agents, Mental Disorders, Humans, Interferons, Ribavirin, Comorbidity, Hepatitis C, Chronic, Substance-Related Disorders
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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