Psychiatric and substance use disorders comorbidities in veterans with hepatitis C virus and HIV coinfection.
OBJECTIVE
A growing number of veterans in the Veterans Health Administration are coinfected with HIV and hepatitis C virus. This review covers timely research relative to comorbid conditions that are common in this population including psychiatric diagnoses, substance use disorders and neurocognitive problems.


RESULTS
Current literature on the psychiatric, substance use disorders and cognitive problems of the coinfected population show that not only are rates of morbidity higher in the coinfected population but that this affects antiviral treatments as well. There is new evidence that brain injuries and infiltration of the virus into the central nervous system may be responsible for cognitive dysfunction. Cotesting, particularly in hepatitis C infected individuals, is not done routinely despite shared risk factors.


CONCLUSIONS
With this understanding of the comorbidities of the coinfected population, integrated healthcare models involving mental health, internal medicine, substance abuse treatment and internal medicine are crucial to work with these medically and psychologically complex patients.
Mental Health Division, Portland Veterans Affairs Medical Center, Portland, Oregon 97210, USA. bret.fuller@va.gov
Bret E
BE
Fuller
Jennifer M
JM
Loftis
Veronica L
VL
Rodriguez
Matthew J
MJ
McQuesten
Peter
P
Hauser
D000998:Antiviral Agents / Q000008:administration & dosage; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D033183:Interdisciplinary Communication; D055118:Medication Adherence / Q000523:psychology; D009483:Neuropsychological Tests; D010348:Patient Care Team; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
D000998:Antiviral Agents