title: The efficacy and safety of treating hepatitis C in patients with a diagnosis of schizophrenia.
abstract: Treating chronic hepatitis C with pegylated interferon alpha may induce or exacerbate psychiatric illness including depression, mania and aggressive behaviour. There is limited data regarding treatment in the context of chronic schizophrenia. We sought to establish the safety and efficacy of treating patients with schizophrenia. Patient and treatment data, prospectively collected on the Scottish hepatitis C database, were analysed according to the presence or absence of a diagnosis of schizophrenia. Time from referral to treatment, and the proportion of patients commencing treatment in each group, was calculated. Outcomes including sustained viral response rates, reasons for treatment termination and adverse events were compared. Of 5497 patients, 64 (1.2%) had a diagnosis of schizophrenia. Patients with schizophrenia (PWS) were as likely to receive treatment as those without [28/61(46%) vs 1639/4415 (37%) P = 0.19]. Sustained viral response (SVR) rates were higher in PWS [21/25 (84%) vs 788/1453 (54%) P < 0.01]. SVR rates by genotype were similar [4/8 (50%) vs 239/684 (35%) Genotype 1 (P = 0.56), 17/17 (100%) vs 599/742 (81%) non-Genotype 1 (P = 0.09)]. Adverse events leading to cessation of treatment were comparable [2/25(8%) vs 189/1453 (13%) P: 0.66]. Patients with schizophrenia are good candidates for hepatitis C treatment, with equivalent SVR and treatment discontinuation rates to patients without schizophrenia.
authors.affiliation: Gastrointestinal Unit Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Mustafa
authors.forename: J
authors.initials: J
authors.lastname: Schofield
authors.forename: P R
authors.initials: PR
authors.lastname: Mills
authors.forename: M
authors.initials: M
authors.lastname: Priest
authors.forename: R
authors.initials: R
authors.lastname: Fox
authors.forename: S
authors.initials: S
authors.lastname: Datta
authors.forename: J
authors.initials: J
authors.lastname: Morris
authors.forename: E H
authors.initials: EH
authors.lastname: Forrest
authors.forename: R
authors.initials: R
authors.lastname: Gillespie
authors.forename: A J
authors.initials: AJ
authors.lastname: Stanley
authors.forename: S T
authors.initials: ST
authors.lastname: Barclay
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications*; D012606:Scotland; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha
keywords: hepatitis C; pegylated interferon alpha; schizophrenia