TY - JOUR
T1 - Co-occurring hepatitis C, substance use, and psychiatric illness
T2 - Treatment issues and developing integrated models of care
AU - Sylvestre, Diana L.
AU - Loftis, Jennifer M.
AU - Hauser, Peter
AU - Genser, Sander
AU - Cesari, Helen
AU - Borek, Nicolette
AU - Kresina, Thomas F.
AU - Seeff, Leonard
AU - Francis, Henry
N1 - Funding Information:
in Bethesda, Maryland. The conference was sponsored by the Center for AIDS and Other Medical Consequences of Drug Abuse (CAMCODA); National Institute of Drug Abuse and Division of Digestive Diseases and Nutrition; National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK); National Institutes of Health; Department of Health and Human Services; and Veterans Administration.
PY - 2004/12
Y1 - 2004/12
N2 - Hepatitis C virus (HCV) infection is transmitted by infection drug use and associated with psychiatric conditions. Patients with drug use or significant psychiatric illness have typically been excluded from HCV treatment trials noting the 1997 National Institutes of Health Consensus Statement on HCV that indicated active drug use and major depressive illness were contraindications to treatment of HCV infection. However, the 2002 NIH Consensus Statement recognized that these patients could be effectively treated for HCV infection and recommended that treatment be considered on a case-by-case basis. Treating HCV infection in these patients is challenging, with drug use relapse possibly leading to psychosocial instability, poor adherence, and HCV reinfection. Interferon therapy may exacerbate preexisting psychiatric symptoms. Co-occurring human immunodeficiency virus or hepatitis B virus provide additional challenges, and access to ancillary medical and psychiatric services may be limited. Patients with co-occurring HCV infection, substance use, and psychiatric illness can complete interferon treatment with careful monitoring and aggressive intervention. Clinicians must integrate early interventions for psychiatric conditions and drug use into their treatment algorithm. Few programs or treatment models are designed to manage co-occurring substance use, psychiatric illness, and HCV infection and therapy. The National Institute on Drug Abuse convened a panel of experts to address the current status and the long-range needs through a 2-day workshop, Co-occurring Hepatitis C, Substance Abuse, and Psychiatric Illness: Addressing the Issues and Developing Integrated Models of Care. This conference report summarizes current data, medical management issues, and strategies discussed.
AB - Hepatitis C virus (HCV) infection is transmitted by infection drug use and associated with psychiatric conditions. Patients with drug use or significant psychiatric illness have typically been excluded from HCV treatment trials noting the 1997 National Institutes of Health Consensus Statement on HCV that indicated active drug use and major depressive illness were contraindications to treatment of HCV infection. However, the 2002 NIH Consensus Statement recognized that these patients could be effectively treated for HCV infection and recommended that treatment be considered on a case-by-case basis. Treating HCV infection in these patients is challenging, with drug use relapse possibly leading to psychosocial instability, poor adherence, and HCV reinfection. Interferon therapy may exacerbate preexisting psychiatric symptoms. Co-occurring human immunodeficiency virus or hepatitis B virus provide additional challenges, and access to ancillary medical and psychiatric services may be limited. Patients with co-occurring HCV infection, substance use, and psychiatric illness can complete interferon treatment with careful monitoring and aggressive intervention. Clinicians must integrate early interventions for psychiatric conditions and drug use into their treatment algorithm. Few programs or treatment models are designed to manage co-occurring substance use, psychiatric illness, and HCV infection and therapy. The National Institute on Drug Abuse convened a panel of experts to address the current status and the long-range needs through a 2-day workshop, Co-occurring Hepatitis C, Substance Abuse, and Psychiatric Illness: Addressing the Issues and Developing Integrated Models of Care. This conference report summarizes current data, medical management issues, and strategies discussed.
KW - Comorbidities
KW - HCV
KW - HIV
KW - Psychiatric illness
KW - Treatment
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UR - http://www.scopus.com/inward/citedby.url?scp=4644319070&partnerID=8YFLogxK
U2 - 10.1093/jurban/jth153
DO - 10.1093/jurban/jth153
M3 - Review article
C2 - 15466851
AN - SCOPUS:4644319070
SN - 1099-3460
VL - 81
SP - 719
EP - 734
JO - Journal of Urban Health
JF - Journal of Urban Health
IS - 4
ER -