Interferon-alpha can be used successfully in patients with hepatitis C virus-positive chronic hepatitis who have a psychiatric illness.
OBJECTIVE
To determine whether individuals with concurrent active psychiatric disease and chronic hepatitis C virus (HCV) can be treated safely and effectively with interferon-alpha.


METHODS
Prospective, open label study.


METHODS
Tertiary referral hospital.


METHODS
Thirty-one consecutive patients with co-existent chronic HCV and a psychiatric illness.


METHODS
Interferon-alpha was administered at doses of either 5 MU three times per week for 6 months (n = 17) or 5 MU daily for 6 months (n = 14).


METHODS
HCV-RNA in serum was measured using reverse transcriptase polymerase chain reaction. Serum alanine aminotransferase levels were assessed and liver biopsy was performed before and after 6 months of treatment and again after 6 months of follow-up.


RESULTS
Twenty-nine of the 31 patients completed 6 months of therapy. Two patients discontinued therapy after 2 and 3 months of treatment. Serum alanine aminotransferase levels returned to normal in 22 (71%) patients. Fifteen (48%) of the 31 patients cleared HCV-RNA from their serum. Only four patients experienced a worsening of their psychiatric illness during treatment. Interferon therapy was discontinued in two of these patients.


CONCLUSIONS
Patients with a co-existent psychiatric illness and chronic HCV can be treated successfully with interferon-alpha with the active participation of a psychiatrist and the maintenance of psychotropic drug therapy during interferon treatment.
Van Thiel
D H
DH
Oklahoma Transplant Institute, Baptist Medical Center of Oklahoma, Oklahoma City 73112, USA.
Friedlander
L
L
Molloy
P J
PJ
Fagiuoli
S
S
Kania
R J
RJ
Caraceni
P
P
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D002908:Chronic Disease; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000188:drug therapy; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis
D016898:Interferon-alpha; D012367:RNA, Viral; D000410:Alanine Transaminase