Table 2 Key narratives in research on HCV, mental health and antiviral therapy

Preparation for HCV antiviral

Bonner et al. [18]

Review of clinical experience

This paper sought to highlight critical pre-treatment strategies and provide tangible resources for HCV clinicians to facilitate preparation and successful treatment of these patients.

HCV clinicians (gastroenterologists/hepatologists) are in a unique position to prepare patients with co-existing MH and/or SA issues for antiviral therapy. Safely treat these populations with multidisciplinary care. Specialist, hospital clinicfocus.

Hong et al. [19]

Clinical case study

Case presentation of a 50 year-old man with HCV and an extensive history involving alcoholism,depression, and suicidiality who participated in a psycho-education group to help prepare him for treatment with pegylated alpha/ribavirin interferon therapy.

Psycho-education groups show promise to prepare patients for intensive medical treatment. The challenge is to help patients overcome barriers to treatment, particularly psycho-social problems, because available treatments are increasingly effective.

Rifai et al. [20]

Literature Review (1972-2009)

Review summary of the psychiatric implications of HCV infection and strategies for the management of interferon alfa-induced neuropsychiatric adverse effects.

Interferon can be safely administered to patients with psychiatric disorders provided there is comprehensive pre-treatment assessment, a risk-benefit analysis, and intensive ongoing medical and psychiatric follow-up.

Sylvestre & Zweben [30]

Descriptive report

Report of a peer-based HCV model to address barriers to treatment intervention.

Peer-based model was successful at engaging, educating, and treating drug users and can facilitate their successful screening and treatment

Knott et al. [21]

Evaluation study

Evaluation of the effect of integrating psychiatric and medical care on evaluation for and initiation of antiviral treatment.

An integrated MH and medical approach was associated with rates of antiviral therapy recommendation and initiation similar to patients without risk for psychiatric or substance use problems.

Adherence/completion antiviral therapy

Norman et al. [22]

Research article

Description of an evaluation of a peer-based integrated model of care.

A high level of patient acceptability by patients using the service.

Dollarhide et al. [23]

Retrospective chart review

To evaluate the impact of common psychiatric disorders on treatment completion of antiviral therapy prescribed to a series of hepatitis C (virus) positive US veterans.

Prior psychiatric or substance use history did not predict completion of recommended IFN/ribavirin treatment. Findings. suggest a larger pool of veterans with psychiatric or substance use disorders may be considered for antiviral therapy when provided with multidisciplinary support.

Clinical outcomes

Schaefer et al. [24]

Meeting report/EU Consensus statement

Summary of current knowledge of HCV infection, antiviral treatment and mental health.

The experience of the last 10 years has clearly shown that patients with psychiatric co-morbidity should not necessarily be excluded from IFN-a-based antiviral therapy.

Freedman & Nathanson [25]

Literature review (2003-2007)

Review of evidence-based best clinical practice of HCV with IFN-based therapy in patients with severe mental illness (SMI) and substance use disorders (SUDs).

clinical outcomes comparable with those without these comorbidities.

Schaefer et al. [26]

Prospective study

Investigated and compared the results of treating the chronic hepatitis C (HCV) infection of different groups of psychiatric-risk patients and controls with pegylated interferon alpha plusribavirin.

Psychiatric diseases and/or drug addiction did not negatively influence psychiatric tolerability of and antiviral response rate to HCV treatment with pegylated interferon alpha plus ribavirin.

Mistler [27]

Clinical case report

Report on three patients with hepatitis C infection, severe mental illness, and substance use disorders.

Patients were successfully treated for hepatitis C (cleared the virus) with carefully monitoring and psychiatric oversight.

Sylvestre et al. [28]

Conference report

Summarises current management issues.

Selected substance users can be candidates for HCV treatment even in the setting of psychiatric disease and relapse to drug use.

Loftis & Hauser [8]

Review

Examines co-management models of care for HCV patients with psychiatric and substance use.

Many patients with comorbid use diagnoses can be treated safely and effectivelypsychiatric and substance with co-management strategies.