Schizophrenic psychosis: a contraindication for treatment of hepatitis C with interferon alpha?
Depressive or psychotic symptoms are a well known side-effect of interferon alpha (INF-alpha). Therefore, the questions arises whether a chronic psychosis should be considered a contraindication for the treatment of active hepatitis C with INF-alpha. We report on a 38-year-old woman with a chronic schizophrenic psychosis, who acquired chronic aggressive hepatitis C. Considering the young age of the woman, the potential risk of developing a hepatocellular carcinoma and the result of the liver biopsy, treatment with interferon alpha 2 b (3x5 million IU/week) was started. The patient was seen three times a week, her psychiatric condition was monitored using the positive and negative symptoms score (PANSS). No signs of psychotic or depressive symptoms appeared during INF-alpha therapy. During the first 6 months the liver enzymes dropped slowly but the virus load was increasing. After adding ribavirin to the therapy, the liver enzymes dropped again, and the PCR carried out 9 months after initiation and 6 months after the end of the 12 months INF-alpha treatment did not detect any virus RNA. This positive result should encourage prospective studies including patients with these two diagnoses on whether patients benefit from INF-alpha.
Dobmeier
M
M
Clinic for Psychiatry and Psychotherapy of the University of Regensburg, Germany. matthias.dobmeier@bzk.uni-regensburg.de
Frick
E
E
Frank
S
S
Franke
C
C
Wolfersdorf
M
M
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002908:Chronic Disease; D000075202:Contraindications; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000628:therapy* / Q000821:virology; D006801:Humans; D007370:Interferon Type I / Q000627:therapeutic use; D008111:Liver Function Tests; D011569:Psychiatric Status Rating Scales; D011994:Recombinant Proteins; D012559:Schizophrenia / Q000150:complications*; D019562:Viral Load
D000998:Antiviral Agents; D007370:Interferon Type I; D011994:Recombinant Proteins