Abstract:
Hepatitis C virus (HCV) is highly prevalent in people with mental disorders (PWMDs). However, in the international context of HCV elimination, no previous study has explored the features of seropositive PWMDs with vs. without a positive viral load (VL). We retrospectively retrieved all HCV serology results of patients hospitalized in 2019, 2020 and 2021 in the second-largest psychiatric hospital of France. Using the medical records of all patients found seropositive for HCV, the following data were collected: sex (male, female), age (in years), previous history of illicit drug use except cannabis (yes or no) and previous history of incarceration (yes or no). We conducted a case-control comparison of these variables between the PWMDs who had and did not have a positive VL, thus providing odds ratios and 95% confidence intervals (ORs [95% CI]). In a total of 13,276 inpatients, 2540 (19.1%) underwent at least one HCV serology; 55 of them (2.16%) were found positive. A VL count was performed for 48 of them, finding 15 (31.3%) individuals with active HCV. Compared with those with a negative VL, these 15 individuals were less likely to have previous documented illicit drug use (OR = 0.18; 95% CI [0.05-0.68]) and to have been previously incarcerated (OR = 0.23; 95% CI [0.06-0.99]); age and sex did not statistically differ. In the context of HCV elimination, PWMDs yet to be treated for HCV are more likely to be those with no identified risk factor for HCV, which supports a strategy of systematic screening for HCV among PWMDs.
摘要:
丙型肝炎病毒(HCV)在患有精神疾病(PWMDs)的人群中非常普遍。然而,在HCV消除的国际背景下,以前没有研究探讨血清阳性的PWMDs与无阳性病毒载量(VL)。我们回顾性检索了2019年,2020年和2021年在法国第二大精神病医院住院的所有HCV血清学结果。使用所有HCV血清阳性患者的医疗记录,收集了以下数据:性别(男性,female),年龄(年),除大麻外的非法药物使用史(是或否)和监禁史(是或否)。我们对有和没有阳性VL的PWMD之间的这些变量进行了病例对照比较,从而提供比值比和95%置信区间(OR[95%CI])。在总共13276名住院病人中,2540(19.1%)接受了至少一种HCV血清学检查;其中55(2.16%)为阳性。对其中48人进行了VL计数,发现15例(31.3%)活跃的HCV个体。与VL为负的相比,这15名患者以前有非法药物使用记录(OR=0.18;95%CI[0.05~0.68])和以前曾被监禁(OR=0.23;95%CI[0.06~0.99])的可能性较小;年龄和性别没有统计学差异.在HCV消除的背景下,尚未接受HCV治疗的PWMDs更可能是那些没有确定的HCV危险因素的患者,这支持在PWMD中系统筛查HCV的策略。