Hepatitis C virus infection among institutionalised psychiatric patients: a regression analysis of indicators of risk

Background/Aims: Institutionalised psychiatric patients are at increased risk of developing chronic infection with hepatitis B virus (HBV). However, little information is available on transmission and epidemiology of hepatitis C virus (HCV) in this setting. The aim of this study was to identify pote...

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Published in:Journal of hepatology 1997-09, Vol.27 (3), p.455-463
Main Authors: Cividini, Agostino, Pistorio, Angela, Regazzetti, Angelo, Cerino, Antonella, Tinelli, Carmine, Mancuso, Anna, Ribola, Massimo, Galli, Maria Laura, Agnusdei, Antonio, Leone, Manuela, Silini, Enrico, Mondelli, Mario U.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Case-Control Studies
Epidemiology
Female
Hepatitis C - epidemiology
Hepatitis C - transmission
Hepatitis C virus
Hospitals, Psychiatric
Human viral diseases
Humans
Infectious diseases
Institutionalization
Italy - epidemiology
Logistic Models
Male
Medical sciences
Middle Aged
Prevalence
Psychiatric institutions
Regression Analysis
Risk Factors
Viral diseases
Viral hepatitis
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Summary:Background/Aims: Institutionalised psychiatric patients are at increased risk of developing chronic infection with hepatitis B virus (HBV). However, little information is available on transmission and epidemiology of hepatitis C virus (HCV) in this setting. The aim of this study was to identify potential risk factors of acquiring HCV infection in two large psychiatric institutions in northern Italy. Methods: We designed a case-control study using randomly selected controls from the same study database, consisting of a total of 1180 patients, in order to satisfy the principle that both cases and controls should be representative of the same base experience. A multiple regression logistic analysis was used to identify features that could predict exposure to HXV as evidenced by the presence of circulating anti-HCV antibodies. Results: Anti-HCV was detected in 79 patients (6.7%). The prevalence of viraemia and the distribution of genotypes were very similar to those found in subjects with chronic HCV infection drawn from the same geographical area. Multivariate analysis indicated that a diagnosis of psychosis and a history of trauma were statistically significant independent risk factors associated with a positive anti-HCV result (OR 2.615, 1.273—5.373 95% CI and OR 2.096, 1.133–3.877 95% CI, respectively). Conclusions: The findings of this large epidemiological study show for the first time that prolonged residence in psychiatric institutions does not entail per se a significant risk of acquiring HCV infection. Since transmission of HCV in this setting appears to occur predominantly via classical parenteral routes, simple prophylactic measures appear to be adequate to prevent infection.
ISSN:0168-8278
1600-0641
DOI:10.1016/S0168-8278(97)80348-0