hepatitis c – Go Retire Psychiatrist

I heard a song on the KCCK Big Mo Blues Show that I first heard in June of 2025. The song is “Artificial” by Walter Trout.

At first blush, I agree with what I think is the point of the song, which is basically a protest against artificiality which could manifest in a range of ways from superficiality and dishonesty in communications, attitudes, style of clothing, relationships, and all the way to Artificial Intelligence (AI).

The other connection I make is to the artist himself. Walter Trout developed Hepatitis C (eventually leading to liver transplant) according to a Wikipedia article which connected his lifestyle to contracting the disease. In my role as a consultation-liaison psychiatrist, I saw many patients with Hepatitis C who were referred to psychiatry from gastroenterology.

I was the main psychiatrist who evaluated them for treatment with Interferon-alpha. At the time it was the only treatment for Hepatitis C and was frequently associated with many side effects including depression. I was also one of the psychiatrists consulted as part of liver transplant evaluations.

Trout got very sick from Hepatitis C and made a remarkable (even miraculous) recovery after his liver transplant. Interferon is no longer used to treat Hepatitis C. It has been replaced by direct-acting antiviral (DAA) agents. They’re much better-tolerated and more effective.

The other aspect relevant to Trout’s song is ironic. The newest scientific literature supports the idea that AI can be helpful for diagnosing Hepatitis C, predicting its progression and response to treatment.

That doesn’t mean I’m completely sold on AI.

Aside from that, there’s interesting research suggesting that there may be a link between schizophrenia and bipolar disorder and Hepatitis C infection (which could be hiding deep in the brain’s choroid plexus lining the cerebral ventricles). In other words, some people might have mental illness because of the liver disease itself.

If you think about the dictionary definition of the word “artificial,” you can hardly dismiss this kind of research as insincere.

There is a very informative CDC media briefing transcript about why so few Americans are getting tested and treated for Hepatitis C.

I’m a retired consultation-liaison psychiatrist and I used to be the go-to consultant to the hepatology clinic back when the only treatment was interferon-alpha. Because interferon-alpha was associated with neuropsychiatric side effects, notably treatment-emergent depression, I was frequently called to help assess potential treatment candidates and on-going follow-up for some.

A significant number of patients could not tolerate the psychiatric side effects.

Back in the day, interferon-alpha was really the only treatment. Now there are many treatments available and Hepatitis C is a curable disease.

Yet, few Americans are taking advantage of the new curative treatment. There are several reasons why, including the barrier of the high cost of treatment and insurance restrictions. The patients with the highest prevalence tend to be younger than age 40 and struggle with injection drug use, commonly opioids.

A large number of those at risk for Hepatitis C don’t know they have the disease. It’s vital to know where free Hepatitis C testing is available, which can be found at the CDC web site.