Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness.

OBJECTIVES This study assessed seroprevalence rates of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) among individuals with severe mental illness. METHODS Participants (n = 931) were patients undergoing inpatient or outpatient treatment in Connecticut, Maryland, New Hampshire, or North Carolina. RESULTS The prevalence of HIV infection in this sample (3.1%) was approximately 8 times the estimated US population rate but lower than rates reported in previous studies of people with severe mental illness. Prevalence rates of HBV (23.4%) and HCV (19.6%) were approximately 5 and 11 times the overall estimated population rates for these infections, respectively. CONCLUSIONS Elevated rates of HIV, HBV, and HCV were found. Of particular concern are the high rates of HCV infection, which are frequently undetected. Individuals with HCV infection commonly fail to receive appropriate treatment to limit liver damage and unknowingly may be a source of infection to others.

[1]  H. Goldman,et al.  Defining and counting the chronically mentally ill. , 1981, Hospital & community psychiatry.

[2]  E. Susser,et al.  Human immunodeficiency virus sexual risk reduction in homeless men with mental illness. , 1998, Archives of General Psychiatry.

[3]  L. Y. Stevenson,et al.  Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention. , 1997, Psychiatric services.

[4]  H. Margolis,et al.  Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease , 1998 .

[5]  F. Cournos,et al.  HIV seroprevalence among people with severe mental illness in the United States: a critical review. , 1997, Clinical psychology review.

[6]  F. Cournos,et al.  AIDS and people with severe mental illness : a handbook for mental health professionals , 1996 .

[7]  Ting Chang,et al.  Hepatitis B and hepatitis C among institutionalized psychiatric patients in Taiwan , 1993, Journal of medical virology.

[8]  Ronald W. Manderscheid,et al.  Mental Health in the United States , 1962, Nature.

[9]  F. Cournos,et al.  HIV infection linked to substance use among hospitalized patients with severe mental illness. , 1998, Psychiatric services.

[10]  H. El‐Serag,et al.  Rising incidence of hepatocellular carcinoma in the United States. , 1999, The New England journal of medicine.

[11]  Alter Mj,et al.  The epidemiology of viral hepatitis in the United States. , 1994 .

[12]  J. Kelly,et al.  HIV risk reduction interventions for persons with severe mental illness. , 1997, Clinical psychology review.

[13]  D. Vlahov,et al.  Update on the seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988-1994. , 1997, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[14]  O. Weiland,et al.  Combined treatment with interferon alpha‐2b and ribavirin for chronic hepatitis C in patients with a previous non‐response or non‐sustained response to interferon alone , 1995, Journal of medical virology.

[15]  R. Drake,et al.  Dartmouth Assessment of Lifestyle Instrument (DALI): a substance use disorder screen for people with severe mental illness. , 1998, The American journal of psychiatry.

[16]  K. Carey,et al.  Risk for human immunodeficiency virus (HIV) infection among persons with severe mental illnesses. , 1997, Clinical psychology review.

[17]  Eugene R. Schiff,et al.  Schiff's Diseases of the Liver , 1999 .

[18]  R. Drake,et al.  Review of integrated mental health and substance abuse treatment for patients with dual disorders. , 1998, Schizophrenia bulletin.

[19]  S. Kalichman,et al.  Factors associated with risk for HIV infection among chronic mentally ill adults. , 1994, The American journal of psychiatry.

[20]  J. Hoofnagle,et al.  Serologic markers of hepatitis B virus infection. , 1986, Seminars in liver disease.

[21]  J. Talbott.  The Chronic mental patient : five years later , 1984 .

[22]  G. Barbarini,et al.  Interferon alpha-2B and ribavirin in combination for patients with chronic hepatitis C who failed to respond to, or relapsed after, interferon alpha therapy: a randomized trial. , 1999, The American journal of medicine.

[23]  K. Carey,et al.  PREVALENCE OF INFECTION WITH HIV AMONG THE SERIOUSLY MENTALLY ILL: REVIEW OF RESEARCH AND IMPLICATIONS FOR PRACTICE , 1995 .

[24]  A. Schinnar,et al.  An empirical literature review of definitions of severe and persistent mental illness. , 1990, The American journal of psychiatry.