Key result
IFN-based antiviral therapy did not significantly increase nonpsychotic mental disorders in CHC patients (19.8% vs 22.4% untreated), though HCV infection increased risk versus NAFLD (HR 1.67).
Why the study?
Does pegylated interferon/ribavirin therapy increase the risk of nonpsychotic mental disorders in mentally healthy chronic hepatitis C patients compared to untreated patients?
Cohort (n=626)
Does pegylated interferon/ribavirin therapy increase the risk of nonpsychotic mental disorders in mentally healthy chronic hepatitis C patients compared to untreated patients?
HCV infection, rather than interferon-based antiviral therapy, is the primary driver of increased risk for nonpsychotic mental disorders in chronic hepatitis C patients.
IFN therapy was not associated with higher nonpsychotic mental disorder risk in CHC; leaves open HCV as primary driver versus NAFLD.
BACKGROUND/PURPOSE: Interferon (IFN) is able to induce significant psychiatric side effects in chronic hepatitis C (CHC) patients, whereas the risk of nonpsychotic mental disorder (NPMD) development in antiviral-treated mentally healthy CHC patients remains obscure. We used a population-based study to assess the risk of NPMD development in patients who had undergone antiviral treatment compared with untreated chronic hepatitis C virus (HCV)-infected and nonalcoholic fatty liver disease (NAFLD) patients. METHODS: Data were retrieved from Taiwan's National Health Insurance Research Database cohort consisting of 1 million individuals for a longitudinal analysis. A total of 313 mentally healthy CHC patients who received IFN-based antiviral therapy were recruited and compared with those without antiviral therapy and NAFLD patients. The Chi-square test was used to obtain the hazard ratio and 95% confidence interval. RESULTS: Among the 313 CHC patients receiving pegylated interferon/ribavirin therapy, 62 patients (19.8%) were associated with NPMD. In the comparison cohort, composed of 313 age- and sex-matched CHC patients not receiving antiviral therapy, 70 patients (22.4%) were associated with NPMD. The Chi-square analysis revealed that antiviral therapy was not significantly associated with NPMD. The diagnosis of HCV-infected hepatitis was independently associated with NPMD when compared with NAFLD. The hazard ratio was 1.67 (95% confidence interval, 1.11-2.52; p = 0.018). Furthermore, generalized anxiety disorder was specifically higher in HCV-infected patients than those with NAFLD. CONCLUSION: Patients with HCV infection are at high risk of developing NPMD with or without IFN-based therapy.
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Chang et al. (2013) conducted a cohort in chronic hepatitis C (CHC) (n=626). IFN-based antiviral therapy (pegylated interferon/ribavirin) vs. No antiviral therapy was evaluated on Nonpsychotic mental disorder (NPMD). IFN-based antiviral therapy did not significantly increase nonpsychotic mental disorders in CHC patients (19.8% vs 22.4% untreated), though HCV infection increased risk versus NAFLD (HR 1.67).
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