Treatment of Hepatitis C in Psychiatric Patients
Treatment of Hepatitis C in Psychiatric Patients
Psychiatric disorders or drug addiction are often regarded as contraindications against the
 use of Interferon-alpha in patients with chronic hepatitis C. The investigators aim is/was to
 get prospective data about adherence, efficacy and mental side effects of IFN-alpha treatment
 in different psychiatric risk groups compared to controls. In a prospective trial, 81
 patients with chronic hepatitis C (positive HCV-RNA and elevated ALT) and psychiatric
 disorders (n=16), methadone substitution (n=21), former drug addiction (n=21) or controls
 without psychiatric history or addiction (n=23) should be/were treated with a combination of
 IFN-alpha-2a 3 x 3 Mio U/week and ribavirin (1000-1200 mg/day).
Patients from the Munich University outpatient department of psychiatry or gastroenterology
 as well as inpatients with elevated transaminases were tested for HCV-infection and
 considered for our trial to avoid a positive or negative selection. Medical inclusion
 criteria were a detectable serum HCV-RNA level in a PCR-based assay (AMPLICOR®, Roche
 Diagnostics, Branchburg, NJ) for more than 6 months and an elevated alanine aminotransferase
 (ALT > 30 U/L, normal <24 U/L). General exclusion criteria were the presence of other liver
 disease, Child B or C cirrhosis, severe cardiac or neurological disease, co-infection with
 hepatitis B or HIV, hepatocellular carcinoma evaluated by ultrasound and alpha-fetoprotein,
 autoimmune disorders, a neutrophil count below 1500 per cubic millimetre, and a platelet
 count below 75000 per cubic millimetre.
Inclusion Criteria:

 -  Medical inclusion criteria were a detectable serum HCV-RNA level in a PCR-based assay
 (AMPLICOR®, Roche Diagnostics, Branchburg, NJ) for more than 6 months and an elevated
 alanine aminotransferase (ALT > 30 U/L, normal <24 U/L).

 Exclusion Criteria:

 -  General exclusion criteria were the presence of other liver disease

 -  Child B or C cirrhosis

 -  Severe cardiac or neurological disease

 -  Co-infection with hepatitis B or HIV

 -  Hepatocellular carcinoma evaluated by ultrasound and alpha-fetoprotein

 -  Autoimmune disorders

 -  Neutrophil count below 1500 per cubic millimetre

 -  Platelet count below 75000 per cubic millimetre