Mental health professionals should take a more active role in the hepatitis C virus (HCV) treatment arena, suggests an article published in Psychosomatics, the journal of the Academy of Psychosomatic Medicine. The authors advise psychiatrists to become more familiar with the direct-acting antivirals used to treat HCV and be aware of their potential drug interactions with antipsychotic medications. 

The article, titled “Hepatitis C Treatment: Clinical Issues for Psychiatrists in the Post-Interferon Era,” notes a significant overlap between hep C and mental illness in the United States. For instance, recent studies have shown that HCV infection occurs at rates 10 to 20 times higher among incarcerated individuals and those with severe psychiatric issues than the general population.

The report also points out that people living with mental illness are far less likely to have access to hepatitis screening, diagnostic confirmation and referral to care. Experts also noted that HCV is much more commonly diagnosed among people who present for medical treatment in emergency room settings, where there is a high prevalence of mental illness.

“Because multiple barriers exist at every stage of HCV treatment, a portion of patients is lost to follow-up at each step in care,” says Yvonne Marie Chasser, MD, a psychiatrist at Massachusetts General Hospital and lead author of the commentary. This phenomenon is seen in other global health epidemics, such as HIV/AIDS.

The report suggests that mental health professionals consider how direct-acting antivirals for hepatitis C might interact with the psychotropic medications they prescribe to their patients. The University of Liverpool has an online resource on the topic at hep-druginteractions.org. 

Mental health experts are also urging mental health professionals to help reduce barriers to HCV care for their patients and to collaborate with other health care providers in their communities to provide more integrated care.