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Hepatitis C Treatment for People With Severe Mental Illness

Received May 7, 2004; revised June 16, July 28, 2004; accepted March 31, 2005. From Dartmouth Medical School, Hanover NH and New Hampshire Hospital, Concord, NH. Send correspondence and reprint requests to Lisa A. Mistler, M.D., at the New Hampshire Hospital Unit C, 36 Clinton St., Concord, NH 03301. e-mail: Lisa.A.Mistler{at}dartmouth.edu
© 2006 The Academy of Psychosomatic Medicine

Over 4 million people in the United States are chronically infected with hepatitis C virus (HCV), and, if untreated, over 20% of these will progress to more serious disease. Persons with severe mental illness (SMI) have markedly elevated rates of HCV infection, but treatment of persons with SMI and HCV has been controversial. Effective antiviral treatment is available, but side effects include depression and other neuropsychiatric symptoms. This article reviews the available data on neuropsychiatric side effects of interferon (IFN) treatment, discusses the limitations of the current research, and makes recommendations regarding HCV treatment in persons with SMI.

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