Boglione Lucio, Lupia Tommaso, Cariti Giuseppe, Di Perri Giovanni
Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy.
Unit of Infectious Diseases, University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy.
J Infect Chemother. 2020 Jan;26(1):18-22. doi: 10.1016/j.jiac.2019.06.004. Epub 2019 Jul 10.
The presence of psychiatric disorders (PD) in patients affected by chronic hepatitis C (CHC) was a major contraindication for the treatment with interferon (IFN)-based regimens. The novel IFN-free approach using the direct-acting antiviral agents (DAAs) is an interesting and promising chance for these subjects. In this retrospective analysis we focused the attention on the virological response and safety of CHC patients affected by PD and treated with IFN-free regimens. 136 subjects were enrolled in this study. Treatment naïve were 78 (57.3), experienced 58 (42.6%). Major depression was present in 25 patients (18.4%), anxiety disorders in 37 (27.2%), bipolar disorders in 23 (16.9%), schizophrenia in 17 (12.5%), behavioral disturbance in 21 (15.4%), psychosis in 13 (9.5%). Psychoactive medication taken by patients were: benzodiazepines (n = 29, 21.3%), antidepressants (n = 24, 17.6%), neuroleptics (n = 29, 21.3%), mood stabilizers (n = 19, 14%), combinations of different drugs (n = 17, 12.5%). Sustained virological response at 12 weeks of follow-up (SVR12) was observed in 128 patients (94.1%), drop-out were 3 (2.2%). No adverse events or significant drug-related side-effects were reported. The treatment with novel IFN-free therapies against CHC were higher effective and well tolerated also in patients with PD taking psychoactive medications.
慢性丙型肝炎（CHC）患者中存在精神疾病（PD）是基于干扰素（IFN）方案治疗的主要禁忌症。使用直接抗病毒药物（DAA）的新型无干扰素方法对这些患者来说是一个有趣且有前景的选择。在这项回顾性分析中，我们关注了患有PD并接受无干扰素方案治疗的CHC患者的病毒学反应和安全性。本研究共纳入136名受试者。初治患者78例（57.3%），经治患者58例（42.6%）。25例患者（18.4%）患有重度抑郁症，37例（27.2%）患有焦虑症，23例（16.9%）患有双相情感障碍，17例（12.5%）患有精神分裂症，21例（15.4%）有行为障碍，13例（9.5%）有精神病。患者服用的精神活性药物有：苯二氮䓬类（n = 29，21.3%）、抗抑郁药（n = 24，17.6%）、抗精神病药（n = 29，21.3%）、心境稳定剂（n = 19，14%）、不同药物组合（n = 17，12.5%）。128例患者（94.1%）在随访12周时达到持续病毒学应答（SVR12），3例（2.2%）退出研究。未报告不良事件或明显的药物相关副作用。新型无干扰素疗法治疗CHC对服用精神活性药物的PD患者同样有效且耐受性良好。
