European guidelines on management of mental health for people with hepatitis C published
European investigators have developed a consensus statement on hepatitis C and mental health.
Published in the online edition of the Journal of Hepatology, the wide-ranging document assesses evidence concerning the effect of hepatitis C infection and its treatment on the brain and mental health. It also reviews the evidence for the prevalence and risk factors of psychiatric problems in hepatitis C-infected people and makes recommendations regarding the treatment and care of patients with mental health problems.
An estimated 170 million individuals are infected with hepatitis C worldwide. Chronic infection can lead to permanent liver damage and death. There is a high prevalence of psychiatric problems in people with hepatitis C. Some evidence suggests that the infection itself may be a cause, possibly due to its effect on the central nervous system. It is also well known that standard hepatitis C therapy with pegylated interferon and ribavirin can have psychiatric side-effects. These can include depression, fatigue, insomnia and cognitive disturbances.
Given these concerns, the European Liver Patients Association convened a meeting of European investigators in 2011 to develop a consensus statement based on current knowledge of mental health problems during hepatitis C infection and treatment and the treatment of psychiatric-related disorders.
Their recommendations are based on a grading of the quality of current evidence, and cover six broad areas.
Hepatitis C and the brain
Neuropsychiatric side-effects of pegylated interferon
Risk factors for depression or suicide associated with pegylated interferon
The following are recommended before treatment:
During and after treatment:
Management, acute treatment and prevention of psychiatric problems associated with pegylated interferon
New antivirals and pegylated interferon
By Michael Carter
Schaefer M et al. Hepatitis C infection, antiviral treatment and mental health: a European expert consensus statement. J Hepatol, advance online publication, August 2012 (abstract available).