INTERFERON-ALPHA CAN BE USED SUCCESSFULLY IN PATIENTS WITH HEPATITIS-C VIRUS-POSITIVE CHRONIC HEPATITIS WHO HAVE A PSYCHIATRIC-ILLNESS

Objective: To determine whether individuals with concurrent active psy chiatric disease and chronic hepatitis C virus (HCV) can be treated sa fely and effectively with interferon-alpha. Design: Prospective, open label study. Setting: Tertiary referral hospital. Patients: Thirty-one consecutive patients with co-existent chronic HCV and a psychiatric i llness. Interventions: Interferon-alpha was administered at doses of e ither 5 MU three times per week for 6 months (n = 17) or 5 MU daily fo r 6 months (n = 14). Methods: HCV-RNA in serum was measured using reve rse transcriptase polymerase chain reaction. Serum alanine aminotransf erase levels were assessed and liver biopsy was performed before and a fter 6 months of treatment and again after 6 months of follow-up. Resu lts: Twenty-nine of the 31 patients completed 6 months of therapy. Two patients discontinued therapy after 2 and 3 months of treatment. Seru m alanine aminotransferase levels returned to normal in 22 (71%) patie nts. Fifteen (48%) of the 31 patients cleared HCV-RNA from their serum . Only four patients experienced a worsening of their psychiatric illn ess during treatment. Interferon therapy was discontinued in two of th ese patients. Conclusions: Patients with a co-existent psychiatric ill ness and chronic HCV can be treated successfully with interferon-alpha with the active participation of a psychiatrist and the maintenance o f psychotropic drug therapy during interferon treatment.