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Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort]

Laurent Michel 1, 2, * Caroline Lions 3, 4 Maria Winnock 5 Jean-Philippe Lang 6 Marc-Arthur Loko 5 Eric Rosenthal 7 Bruno Marchou 8 Marc Antoine Valantin 9 Philippe Morlat 10 Perrine Roux 3, 4 Philippe Sogni 11 Bruno Spire 3, 4 Isabelle Poizot-Martin 12 Karine Lacombe 13 Caroline Lascoux-Combe 14 Claudine Duvivier 15 Didier Neau 16 François Dabis 5 Dominique Salmon-Ceron 11 Patrizia Carrieri 3, 4, *
* Corresponding author
1 SMSP - U1178 - Santé mentale et santé publique
2 Centre Pierre Nicole [Paris]
3 SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
4 ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]
5 Epidemiologie-Biostatistique [Bordeaux]
6 Laboratoire de Génétique Moléculaire [CHRU Strasbourg]
7 Hôpital l'Archet - Service de Médecine Interne [CHU Nice]
8 Pathologie Infectieuse et Tropicale, Clinique et Biologique [CHU Purpan de Toulouse]
9 Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière]
10 Service de médecine interne et maladies infectieuses [Bordeaux]
11 Service de Gastro-entérologie et hépatologie [AP-HP Hôpital Cochin]
12 Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM]
13 Service des maladies infectieuses et tropicales [CHU Saint-Antoine]
14 Service des Maladies Infectieuses et Tropicales [CHU Saint Louis]
15 Centre d'infectiologie Necker-Pasteur [CHU Necker]
16 Service des Maladies Infectieuses et Tropicales A [Bordeaux]
Abstract : The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. Methods The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/ HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les H epatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). Results Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/ dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-na€ ıve patients. Conclusions Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders.
Keywords : psychiatric disorders HIV coinfection drug/alcohol abuse hepatitis C virus
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INSERM | ANRSCO13 | UNIV-PARIS5 | IRD | UNIV-AMU | U1252 | USPC | UNIV-PARIS | SORBONNE-UNIVERSITE | SU-TI

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Laurent Michel, Caroline Lions, Maria Winnock, Jean-Philippe Lang, Marc-Arthur Loko, et al.. Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort]. HIV Medicine, Wiley, 2016, 17 (10), pp.758-765. ⟨10.1111/hiv.12382⟩. ⟨inserm-01994836⟩

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