Chiu Wei-Che, Lu Mong-Liang, Chang Cheng-Chen
Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan.
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
Psychiatry Investig. 2020 Mar;17(3):268-274. doi: 10.30773/pi.2019.0254. Epub 2020 Mar 11.
This study investigates the association between mental disorders and interferon nontreatment in patients with chronic hepatitis C virus (HCV) infection in a large national sample.
Using the National Health Insurance Research Database of Taiwan, we conducted a nationwide population-based study. Each case was matched to five controls by age, sex, urbanization, and income. Conditional logistic regression was used to assess odds of HCV nontreatment in different mental disorders.
From 1999 to 2013, we identified 92,970 subjects with HCV infection and 15,495 HCV cases (16.7%) had received IFN therapy. Other than chronic obstructive pulmonary disease, the medical diseases and mental disorders were significantly different between IFN and non-IFN treated HCV patients. After adjusting for medical diseases, depressive disorder and anxiety disorder was positively associated with receiving IFN therapy. Patients with schizophrenia, bipolar disorders and alcohol use disorders were significantly less likely to receive interferon. Antidepressant exposure (cumulative daily exposure or cumulative daily dose) was associated with lower odds of IFN treatment.
Our nationwide cohort study demonstrated that INF nontreatment rate was lower in certain mental disorders. Antidepressant exposure might lower the chance of receiving IFN treatment. Our results may help to identify and to overcome the obstacles for HCV treatment and further apply to DAAs regimen.
本研究在一个大型全国样本中调查慢性丙型肝炎病毒（HCV）感染患者的精神障碍与未接受干扰素治疗之间的关联。
利用台湾国民健康保险研究数据库，我们开展了一项基于全国人群的研究。每个病例按照年龄、性别、城市化程度和收入与五个对照进行匹配。采用条件逻辑回归来评估不同精神障碍中未接受HCV治疗的几率。
1999年至2013年期间，我们识别出92,970例HCV感染患者，其中15,495例（16.7%）HCV病例接受了干扰素治疗。除慢性阻塞性肺疾病外，接受干扰素治疗和未接受干扰素治疗的HCV患者之间的内科疾病和精神障碍存在显著差异。在对内科疾病进行校正后，抑郁症和焦虑症与接受干扰素治疗呈正相关。精神分裂症、双相情感障碍和酒精使用障碍患者接受干扰素治疗的可能性显著降低。抗抑郁药暴露（累积每日暴露量或累积每日剂量）与接受干扰素治疗的几率较低相关。
我们的全国队列研究表明，某些精神障碍中干扰素未治疗率较低。抗抑郁药暴露可能会降低接受干扰素治疗的机会。我们的结果可能有助于识别并克服HCV治疗的障碍，并进一步应用于直接抗病毒药物（DAA）治疗方案。
