Prevalence of hepatitis C virus infection in patients with chronic mental disorders: The relevance of dual disorders

Chronic hepatitis C virus (HCV) infection is a treatable condition and remains one of the most common causes of cirrhosis and hepatocellular carcinoma.1, 2, 3, 4 The global seroprevalence of HCV among adults is estimated at 1% for all ages,5, 6 similar to the data recently registered for the general population in Spain.7, 8

The prevalence of HCV infection is higher in people with psychiatric disorders compared to the general population, reaching nearly 20%, among psychiatric in-patients and out-patients.9, 10, 11 Moreover, a recent systematic review and meta-analysis showed the prevalence of blood-borne viral infections in people with serious mental illness was consistently greater than in the general population in regions with a low prevalence of blood-borne viruses, such as Europe and North America, and equivalent to the general population in regions with a high overall prevalence, such as Asia. Regarding HCV infection, the estimated prevalence in patients with severe psychiatric disorders was 17.4% (95% CI 13.2–22.6) in North America, 4.9% (95% CI 3.0–7.9) in Europe and 4.4% (95% CI 2.8–6.9) in Asia.12

Substance-related disorders and addictive disorders are an important risk factor for a variety of medical and psychiatric conditions, and their co-occurrence with another mental disorder defines dual disorders (DD).13 Between 30% and 50% of patients diagnosed with serious mental illnesses suffer from substance abuse disorders which can lead to risk behaviours that foster viral transmission, thus increasing risk of HCV infection.12, 14 Drug users, especially individuals with a history of injecting drugs, have the highest prevalence of HCV infection with rates as high as 14–84% in Europe.15, 16 These groups have unequal access to healthcare compared to the general population, which implies an increased risk of mortality and a major public health challenge.16 The availability of treatments with improved efficacy and tolerability, and the goal of eliminating HCV infection by 2030 established by the World Health Organization (WHO), should promote efforts to prevent, screen and treat HCV infection in these patients.15, 16, 17 Despite the high prevalence of HCV infection in people with psychiatric and/or substance abuse disorders, epidemiological studies in samples of hospitalised patients with chronic mental disorders and DD are lacking.

In light of the above, this study aimed to assess the prevalence of HCV infection and the characteristics that influenced its occurrence in patients with severe mental disorders admitted to the Medium-Term Psychiatric Unit of the University of Salamanca Health Care Complex.

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