Psychiatry Investig.  2020 Mar;17(3):268-274. 10.30773/pi.2019.0254.

Mental Disorders and Interferon Nontreatment in Hepatitis C Virus Infection-a Population Based Cohort Study

Affiliations
  • 1Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
  • 2School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
  • 3Department of Psychiatry, Wan-Fang Hospital, Taipei, Taiwan
  • 4School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  • 5Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
  • 6School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  • 7Center of General Education, Tunghai University, Taichung, Taiwan

Abstract


Objective
This study investigates the association between mental disorders and interferon nontreatment in patients with chronic hepatitis C virus (HCV) infection in a large national sample.
Methods
Using the National Health Insurance Research Database of Taiwan, we conducted a nationwide population-based study. Each case was matched to five controls by age, sex, urbanization, and income. Conditional logistic regression was used to assess odds of HCV nontreatment in different mental disorders.
Results
From 1999 to 2013, we identified 92,970 subjects with HCV infection and 15,495 HCV cases (16.7%) had received IFN therapy. Other than chronic obstructive pulmonary disease, the medical diseases and mental disorders were significantly different between IFN and non-IFN treated HCV patients. After adjusting for medical diseases, depressive disorder and anxiety disorder was positively associated with receiving IFN therapy. Patients with schizophrenia, bipolar disorders and alcohol use disorders were significantly less likely to receive interferon. Antidepressant exposure (cumulative daily exposure or cumulative daily dose) was associated with lower odds of IFN treatment.
Conclusion
Our nationwide cohort study demonstrated that INF nontreatment rate was lower in certain mental disorders. Antidepressant exposure might lower the chance of receiving IFN treatment. Our results may help to identify and to overcome the obstacles for HCV treatment and further apply to DAAs regimen.

Keyword

Hepatitis C, Interferon non-treatment, Mental disorders, Anxiety, Depression
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