Current and future challenges in HCV: insights from an Italian experts panel

Addiction, Anhedonia, and Comorbid Mood Disorder. A Narrative Review

Background: Recently, anhedonia has been recognized as an important Research Domain Criterion (RDoC) by the National Institute of Mental Health. Anhedonia is proposed to play an essential role in the pathogenies of both addictive and mood disorders, and possibly their co-occurrence with a single individual. However, up to now, comprehensive information about anhedonia concerning its underlying neurobiological circuitries, the neurocognitive correlates, and their role in addiction, mood disorder, and comorbidity remains scarce. Aim: In this literature review of human studies, we bring together the current state of knowledge with respect to anhedonia in its relationship with disorders in the use of substances (DUS) and the comorbidity with mood disorders. Method: A PubMed search was conducted using the following search terms: (Anhedonia OR Reward Deficiency) AND ((Drug Dependence OR Abuse) OR Alcohol OR Nicotine OR Addiction OR Gambling OR (Internet Gaming)). Thirty-two articles were included in the review. Results: Anhedonia is associated with substance use disorders, and their severity is especially prominent in DUS with comorbid depression. Anhedonia may be both a trait and a state dimension in its relation to DUS and tends to impact DUS treatment outcome negatively.

Evolution of Pretreatment Assessment and Direct Acting Antiviral Regimens in Accordance with Upgrading Guidelines: A Retrospective Study in HIV/HCV Coinfected Patients

Since the advent of new direct acting antivirals (DAA), substantial changes in hepatitis C (HCV) treatment guidelines have occurred. However, little is known about how these recommendations have been adopted into clinical practice. We conducted a retrospective review of human immunodeficiency virus (HIV)/HCV coinfected patients treated with DAAs at the Ryan White Clinic of the Jackson Health System in Miami, FL, USA. Our aim was to determine changes in HCV evaluation and treatment patterns in the use of DAAs over a four-year period from January 2014 to December 2017. Data were divided into two periods: period 1 (2014⁻2015) and period 2 (2016⁻2017). In comparison with the rest of the cohort, patients in period 2 had a lower frequency of advanced liver disease (24.4% vs. 48.6%, p = 0.026) and underwent more elastography (34.1% vs. 2.7%, p < 0.001) and less ultrasound (78.0% vs. 97.3%, p = 0.011). They were more often treated with ledipasvir/sofosbuvir (85.4% vs. 56.8%, p = 0.005) and less often with simeprevir/sofosbuvir (0% vs. 32.4%, p < 0.001). Gastrointestinal side effects were reported less frequently (2.4% vs. 18.9%, p = 0.017) in this period. In accordance with the updated guidelines, our study demonstrated a growing preference for non-invasive methods to assess fibrosis in recent years. Regarding treatment, there was a clear preference for second generation DAAs in 2016⁻2017, along with initiation of treatment in the early stages of liver disease.