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Psychiatric behavioral aspects of comanagement of hepatitis C virus and HIV

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Abstract

Coinfection with HIV hastens the progression of liver disease in persons with hepatitis C virus (HCV) infection. As mortality directly due to HIV continues to decrease among persons who are HIV-positive, coinfection with HCV has emerged as a leading cause of death. There is increasing attention to the need to actively treat HCV infection in HIV/HCV coinfected patients. Current HCV treatment with pegylated interferon and ribavirin achieves sustained viral response in up to 40% of coinfected patients but has numerous neuropsychiatric side effects. Providers are hesitant to begin HCV treatment in the coinfected population given the high prevalence of existing psychiatric illness, cognitive impairment, and substance use disorders. There is an urgent need for research into the psychiatric and behavioral predictors of HCV treatment adherence and virologic outcome, as well as into the optimal psychiatric management of the neuropsychiatric sequelae of HCV therapy.

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References and Recommended Reading

  1. Bica I, McGovern B, Dhar R, et al.: Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection. Clin Infect Dis 2001, 32:492–497.

    Article  PubMed  CAS  Google Scholar 

  2. Salmon-Ceron D, Lewden C, Morlat P, et al.: Liver disease as a major cause of death among HIV infected patients: role of hepatitis C and B viruses and alcohol. J Hepatol 2005, 42:799–805.

    Article  PubMed  CAS  Google Scholar 

  3. Miller CL, Wood E, Spittal PM, et al.: The future face of coinfection: prevalence and incidence of HIV and hepatitis C coinfection among young injection drug users. J Acquir Immune Defic Syndr 2004, 36:743–749.

    Article  PubMed  Google Scholar 

  4. Hall CS, Charlebois ED, Hahn JA, et al.: Hepatitis C virus infection in San Francisco‘s HIV-infected urban poor: high prevalence but low treatment rates. J Gen Intern Med 2004, 19:357–365.

    Article  PubMed  Google Scholar 

  5. Rauch A, Rickenbach M, Weber R, et al.: Unsafe sex and increased incidence of hepatitis C virus infection among HIV-infected men who have sex with men: the Swiss HIV cohort study. Clin Infect Dis 2005, 41:395–402.

    Article  PubMed  Google Scholar 

  6. Graham CS, Baden LR, Yu E, et al.: Infiuence of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis. Clin Infect Dis 2001, 33:562–569.

    Article  PubMed  CAS  Google Scholar 

  7. Sulkowski MS, Thomas DL: Hepatitis C in the HIVinfected person. Ann Intern Med 2003, 138:197–207.

    PubMed  Google Scholar 

  8. Weis N, Lindhardt BO, Kronborg G, et al.: Impact of hepatitis C virus coinfection on response to highly active antiretroviral therapy and outcome in HIV-infected individuals: a nationwide cohort study. Clin Infect Dis 2006, 42:1482–1487.

    Article  Google Scholar 

  9. Soriano V, Pérez-Olmeda M, Ríos P, et al.: Hepatitis C virus (HCV) relapses after anti-HCV therapy are more frequent in HIV-infected patients. AIDS Res Hum Retroviruses 2004, 20:351–353.

    Article  PubMed  CAS  Google Scholar 

  10. Bräu N: Chronic hepatitis C in patients with HIV/AIDS: a new challenge in antiviral therapy. J Antimicrob Chemother 2005, 56:991–995.

    Article  PubMed  CAS  Google Scholar 

  11. Crabb C: Hepatitis C‘s effect on HIV disease remains elusive despite three new studies. AIDS 2006, 20:N1-N2.

    Article  PubMed  Google Scholar 

  12. Sullivan RS, Hanson DL, Teshale EH, et al.: Effect of hepatitis C infection on progression of HIV disease and early response to initial antiretroviral therapy. AIDS 2006, 20:1171–1179.

    Article  PubMed  Google Scholar 

  13. Braitstein P, Justice A, Bangsberg DR, et al.: Hepatitis C coinfection is independently associated with decreased adherence to antiretroviral therapy in a population-based HIV cohort. AIDS 2006, 20:323–331. Finds poorer HIV treatment adherence among HIV/HCV coinfected patients as compared with HIV monoinfected patients, suggesting that adherence is playing a role in the higher mortality rates among HIV/HCV coinfected patients.

    Article  PubMed  Google Scholar 

  14. Lang CA, Conrad S, Garrett L, et al.: Symptom prevalence and clustering of symptoms in people living with chronic hepatitis C infection. J Pain Symptom Manage 2006, 31:335–344.

    Article  PubMed  Google Scholar 

  15. Yun LWH, Maravi M, Kobayashi JS, et al.: Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients. J AIDS 2005, 38:432–438.

    CAS  Google Scholar 

  16. Goulet JL, Fultz SL, McGinnis KA, Justice AC: Relative prevalence of comorbidities and treatment contraindications in HIV-mono-infected and HIV/HCV-co-infected veterans. AIDS 2005, 19:S99-S105. Documents higher levels of comorbid psychiatric and medical conditions in HIV/HCV coinfected, as compared with HIV monoinfected, US veterans in care in a sample of 25,116 persons.

    Article  PubMed  Google Scholar 

  17. Martin EM, Novak RM, Fendrich M, et al.: Stroop performance in drug users classified by HIV and hepatitis C virus serostatus. J Int Neuropsychol Soc 2004, 10:298–300.

    Article  PubMed  Google Scholar 

  18. Ryan EL, Morgello S, Isaacs K, et al.: Neuropsychiatric impact of hepatitis C on advanced HIV. Neurology 2004, 62:957–962.

    PubMed  CAS  Google Scholar 

  19. Dieperink E, Willenbring M, Ho SB: Neuropsychiatric symptoms associated with hepatitis C and interferon alpha: a review. Am J Psychiatry 2000, 157:867–876.

    Article  PubMed  CAS  Google Scholar 

  20. Schaefer M, Schwaiger M, Pich M, et al.: Neurotransmitter changes by interferon-alpha and therapeutic implications. Pharmacopsychiatry 2003, 36:S203-S206.

    Article  PubMed  CAS  Google Scholar 

  21. Juengling FD, Ebert D, Gut O, et al.: Prefrontal cortical hypometabolism during low-dose interferon alpha treatment. Psychopharmacology 2000, 152:383–389.

    Article  PubMed  CAS  Google Scholar 

  22. Asnis GM, de la Garza R 2nd: Interferon-induced depression in chronic hepatitis C: A review of its prevalence, risk factors, biology, and treatment approaches. J Clin Gastroenterol 2006, 40:322–335.

    Article  PubMed  CAS  Google Scholar 

  23. Torriani FJ, Rodriguez-Torres M, Rockstroh JK, et al.: Pegylated alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients. N Engl J Med 2004, 351:438–450.

    Article  PubMed  CAS  Google Scholar 

  24. Laguno M, Blanch J, Murillas J, et al.: Depressive symptoms after initiation of interferon therapy in human immunodeficiency virus-infected patients with chronic hepatitis C. Antivir Ther 2004, 9:905–909.

    PubMed  CAS  Google Scholar 

  25. National Institutes of Health: National Institutes of Health consensus development conference statement: management of hepatitis C. Hepatology 2002, 36(Suppl 1):3–20.

    Google Scholar 

  26. Sylvestre DL, Loftis JM, Hauser P, et al.: Co-ocurring hepatitis C, substance use, and psychiatric illness: treatment issues and developing integrated models of care. J Urban Health 2004, 81:719–734.

    PubMed  Google Scholar 

  27. Thompson VV, Ragland KE, Hall CS, et al.: Provider assessment of eligibility for hepatitis C treatment in HIVinfected homeless and marginally housed persons. AIDS 2005, 19:S208-S214. Qualitative and quantitative study of the barriers to treating HCV in coinfected patients as viewed by providers treating HIV/HCV coinfected homeless and marginally housed patients.

    PubMed  Google Scholar 

  28. Edlin BR, Seal KH, Lorvick J, et al.: Is it justifiable to withhold treatment for hepatitis C from illicit-drug users? N Engl J Med 2001, 345:211–213.

    Article  PubMed  CAS  Google Scholar 

  29. Wagner GJ, Ryan GW: Hepatitis C virus treatment decision-making in the context of HIV co-infection: the role of medical, behavioral and mental health factors in assessing treatment readiness. AIDS 2005, 19:S190-S198. Review article which provides a comprehensive overview of the medical and behavioral factors which affect providers‘ assessment of HCV treatment readiness in coinfected patients and integrates the relevant HIV and HCV study findings.

    Article  PubMed  Google Scholar 

  30. Adeyemi OM, Jensen D, Attar B, et al.: Hepatitis C treatment eligibility in an urban population with and without HIV coinfection. AIDS Patient Care STDS 2004, 18:239–245.

    Article  PubMed  Google Scholar 

  31. Mehta SH, Thomas DL, Sulkowski MS, et al.: A framework for understanding factors that affect access and utilization of treatment for hepatitis C virus infection among HCV-mono-infected and HIV/HCV-co-infected injection drug users. AIDS 2005, 19:S179–189.

    Article  PubMed  Google Scholar 

  32. Taylor LE, Gholam PM, Schwartzapfel B, Rich JD. Hepatitis C treatment in HIV-HCV-coinfected patients with drug addiction and psychiatric illness: a case report. AIDS Reader 2005, 15:629–638.

    PubMed  Google Scholar 

  33. Strauss SM, Astone JM, Des Jarlais DC, Hagan H: Integrating hepatitis C services into existing HIV services: the experiences of a sample of U.S. drug treatment units. AIDS Patient Care STDS 2005, 19:78–88.

    Article  PubMed  Google Scholar 

  34. McGovern B, Fiore J, Wurcel A, et al.: Delivering therapy for hepatitis C virus infection to incarcerated HIV-seropositive patients. Clin Infect Dis 2005, 41:S56-S62.

    Article  PubMed  Google Scholar 

  35. Kresina TF, Bruce RD, Cargill VA, Cheever LW: Integrating care for hepatitis C virus (HCV) and primary care for HIV for injection drug users coinfected with HIV and HCV. Clin Infect Dis 2005, 41:S83-S88.

    Article  PubMed  Google Scholar 

  36. Conway B, Grebely J, Tossonian H, et al.: A systematic approach to the treatment of HIV and hepatitis C virus infection in the inner city: a Canadian perspective. Clin Infect Dis, 41:S73–78.

  37. Carrat F, Bani-Sadr F, Pol S, et al.: Pegylated interferon alfa-2b vs standard interferon alfa 2b, plus ribavirin, for chronic hepatitis C in HIV-infected patients: a randomized controlled trial. JAMA 2004, 292:2839–2848.

    Article  PubMed  CAS  Google Scholar 

  38. Chung RT, Andersen J, Volberding P, et al.: Peginterferon alfa-2a plus ribavirin versus interferon alfa-2a plus ribavirin for chronic hepatitis C in HIV-coinfected persons. N Engl J Med 2004, 351:451–459.

    Article  PubMed  CAS  Google Scholar 

  39. Laguno M, Murillas J, Blanco JL, et al.: Peg alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for treatment of HIV/HCV co-infected patients. AIDS 2004, 18:F27-F36.

    Article  PubMed  CAS  Google Scholar 

  40. Santin M, Shaw E, Garcia MJ, et al.: Efficacy and safety of pegylated interferon-alfa 2b plus ribavirin for the treatment of chronic hepatitis C in HIV-infected patients. AIDS Res Hum Retroviruses 2006, 22:315–320.

    Article  PubMed  CAS  Google Scholar 

  41. Solá R, Galera JA, Montoliu S, et al.: Poor response to hepatitis C virus (HCV) therapy in HIV-and HCV-coinfected patients is not due to lower adherence to treatment. AIDS Res Hum Retroviruses 2006, 22:393–400.

    Article  PubMed  Google Scholar 

  42. Musselman DL, Lawson DH, Gumnick JF, et al.: Paroxetine for the prevention of depression induced by high-dose interferon alfa. N Engl J Med 2001, 344:961–966.

    Article  PubMed  CAS  Google Scholar 

  43. Hoffman RG, Cohen MA, Alfonso CA, et al.: Treatment of interferon-induced psychosis in patients with comorbid hepatitis C and HIV. Psychosomatics 2004, 44:417–420.

    Article  Google Scholar 

  44. Cohen MAA, Alfonso CA: AIDS psychiatry: psychiatric and palliative care, and pain management. In AIDS and Other Manifestations of HIV Infection, edn 4. Edited by Wormser GP. New York: Elsevier; 2004:537–576.

    Google Scholar 

  45. McHutchison JG, Manns M, Patel K, et al.: Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology, 2002, 123:1061–1069.

    Article  PubMed  CAS  Google Scholar 

  46. Schaefer M, Schmidt F, Folwaczny C, et al.: Adherence and mental side effects during hepatitis C treatment with interferon alfa and ribavirin in psychiatric risk groups. Hepatology 2003, 37:443–451.

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Psychiatry, Mount Sinai School of Medicine, 1160 Fifth Avenue, Box 1228, 10029, New York, NY, USA

    Jeffrey J. Weiss PhD

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  1. Jeffrey J. Weiss PhD
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  2. Jack M. Gorman MD
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Correspondence to Jeffrey J. Weiss PhD.

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Weiss, J.J., Gorman, J.M. Psychiatric behavioral aspects of comanagement of hepatitis C virus and HIV. Curr HIV/AIDS Rep 3, 176–181 (2006). https://doi.org/10.1007/s11904-006-0013-2

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