Interferon-based hepatitis C treatment in patients with pre-existing severe mental illness and substance use disorders.

Hepatitis C infection in patients with mental illness and drug addiction is highly prevalent and infrequently treated. Over the past 5 years, a wealth of studies specifically focused on these groups have demonstrated comparable rates of sustained virological response, compliance and adverse events. Optimization of psychotropic and opioid-replacement therapy with integrated psychiatric/addiction treatment prior to and during IFN-alpha initiation produces optimal results. Experience in treating these populations demonstrates clinical outcomes comparable with those without these comorbidities. Patients with mental illness and drug addiction should have routine screening and treatment for HCV infection to prevent associated morbidity and mortality.