Neuropsychiatric side effects of HCV therapy and their treatment:: focus on IFNα-induced depression

Hepatologists and other health care providers are increasingly recognizing the need for a systematic approach to managing hepatitis C virus (HCV) infection that takes into account the common comorbid conditions of psychiatric disorders and substance use disorders (SUDS) [1-7]. The majority of new and existing cases of HCV infection are related to injection drug use [8], and this patient Population has a high prevalence of psychiatric comorbidity. In addition, interferon alfa (IFNalpha), a mainstay of HCV treatment, causes a variety of neuropsychiatric side effects, particularly depression, in a significant proportion of patients [1,2,5,9,10]. These side effects call result in dose reductions or necessitate discontintiation of IFNalpha therapy, and they can decrease patient quality of life significantly. In light of emerging data that HCV treatment adherence might be associated with improved antiviral therapy outcomes [11, 12], the identification and appropriate management of psychiatric illness and neuropsychiatric side effects in patients who have hepatitis C might be particularly important in ensuring that such patients receive optimum antiviral therapy and experience potentially improved treatment Outcomes [13].