Department of Psychiatry, Oregon Health and Science University, Portland, Oregon, USA.
Schizophr Bull. 2010 Jan;36(1):165-72. doi: 10.1093/schbul/sbn065. Epub 2008 Jun 17.
Despite disproportionately high rates of hepatitis C (HCV) among patients with severe mental illness, to date, there is scant empirical data available regarding antiviral therapy outcomes within this population.
To compare antiviral therapy completion and response rates between HCV patients with vs those without schizophrenia (SCHZ).
A regional Veterans Healthcare Administration database was used to identify veterans meeting criteria for this retrospective chart review. All patients confirmed to have SCHZ and to have received antiviral therapy between 1998 and 2006 (n = 30) were compared with a control group of demographically matched (HCV genotype, age, race, gender) patients with no history of SCHZ (n = 30).
For HCV patients with genotype 1, antiviral completion, end of treatment response (ETR), and sustained viral response (SVR) rates did not significantly differ between groups. For those with genotypes 2 and 3 combined, antiviral therapy completion rates did not significantly differ between groups; however, the SCHZ group was significantly (P < 0.050) more likely to achieve an ETR and an SVR. For all genotypes combined, the SCHZ patients were no more likely than controls to discontinue therapy early for psychiatric symptoms, medical complications, or other adverse events, and groups did not significantly differ in terms of hospitalization rates during antiviral therapy.
Our retrospective chart review suggests that patients with SCHZ complete and respond to antiviral therapy for HCV at rates comparable with those without SCHZ. Based on these data, SCHZ should not be considered a contraindication to antiviral therapy for HCV.
尽管患有严重精神疾病的患者丙型肝炎(HCV)的发病率高得不成比例,但迄今为止,针对该人群的抗病毒治疗结果,几乎没有可用的经验数据。
比较有和没有精神分裂症(SCHZ)的 HCV 患者的抗病毒治疗完成率和应答率。
使用区域退伍军人医疗保健管理局数据库来确定符合本回顾性图表审查标准的退伍军人。所有被证实患有 SCHZ 并在 1998 年至 2006 年间接受抗病毒治疗的患者(n = 30)与一组无 SCHZ 病史的匹配(HCV 基因型、年龄、种族、性别)患者(n = 30)进行比较。
对于基因型 1 的 HCV 患者,两组间抗病毒治疗完成率、治疗结束时应答(ETR)和持续病毒应答(SVR)率无显著差异。对于基因型 2 和 3 合并的患者,两组间抗病毒治疗完成率无显著差异;然而,SCHZ 组获得 ETR 和 SVR 的可能性明显更高(P < 0.050)。对于所有基因型合并,SCHZ 患者因精神症状、医疗并发症或其他不良事件而提前停止治疗的可能性不比对照组高,且两组在抗病毒治疗期间的住院率方面无显著差异。
我们的回顾性图表审查表明,患有 SCHZ 的患者完成和对 HCV 的抗病毒治疗的应答率与没有 SCHZ 的患者相当。基于这些数据,SCHZ 不应被视为 HCV 抗病毒治疗的禁忌症。