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Pham-Scottez A, Dauriac-Le Masson V, Ben Dahman O, Toquin A, Benmostefa A, Hallouche N. Retrospective study of hepatitis C screening and seroprevalence in the GHU Paris. L'ENCEPHALE 2024:S0013-7006(24)00139-8. [PMID: 39244499 DOI: 10.1016/j.encep.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES The prevalence of hepatitis C virus (HCV) has been estimated to be approximately ten times higher in patients with psychiatric disorders, but European data are rare and only two French studies have recently been published on the subject. Our objective was to determine the HCV screening rate and the prevalence of HCV in adult patients hospitalised in the largest French psychiatric hospital. METHODS We conducted a retrospective study of all adult patients hospitalised at GHU Paris, from 2019 to 2022, including age, gender, HCV screening, HCV serological status, and the existence of an ICD-10 diagnosis of psychoactive substance use disorder. Descriptive statistics used means±standard deviations and percentages. Bivariable comparisons used Student's t test and Chi-square test. RESULTS The overall HCV screening rate was 55.4% and increased over the four years from 37.1% in 2019 to 69.4% in 2022. Patients screened were significantly younger people and with a substance use disorder than unscreened patients. The prevalence of HCV over this 4-year period was 2.8% and remained stable. The HCV-positive patients were significantly more male, older and more likely to have substance use disorders than the HCV-negative patients. CONCLUSIONS We found a prevalence rate of HCV ten times higher than the prevalence in the general population, in line with findings in many other European countries. The eradication of HCV will not be possible without the elimination of this "forgotten reservoir" of the virus. Efforts must be made in psychiatric hospitals to test all patients in order to treat patients suffering from hepatitis C with direct-acting antivirals.
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Affiliation(s)
- Alexandra Pham-Scottez
- Cellule universitarisation recherche et enseignement, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France; Université Versailles Saint-Quentin, université Paris-Saclay, Inserm U1018, CESP, team DevPsy, Villejuif, France.
| | - Valérie Dauriac-Le Masson
- Département d'information médicale, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Oumeyma Ben Dahman
- Laboratoire de biologie, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Armel Toquin
- Pôle soins somatiques, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Amine Benmostefa
- Laboratoire de biologie, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
| | - Nabil Hallouche
- Pôle soins somatiques, GHU Paris psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
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Thomas MD, Vittinghoff E, Koester KA, Dahiya P, Riano NS, Cournos F, Dawson L, Olfson M, Pinals DA, Crystal S, Walkup J, Shade S, Mangurian C, Arnold EA. Examining the Impact of State-Level Factors on HIV Testing for Medicaid Enrollees With Schizophrenia. J Acquir Immune Defic Syndr 2023; 94:18-27. [PMID: 37229531 PMCID: PMC10524352 DOI: 10.1097/qai.0000000000003225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/22/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND People with schizophrenia experience unique barriers to routine HIV testing, despite increased risk of HIV compared with the general US population. Little is known about how health care delivery system factors affect testing rates or whether there are testing differences for people with schizophrenia. SETTING Nationally representative sample of Medicaid enrollees with and without schizophrenia. METHODS Using retrospective longitudinal data, we examined whether state-level factors were associated with differences in HIV testing among Medicaid enrollees with schizophrenia compared with frequency-matched controls during 2002-2012. Multivariable logistic regression estimated testing rate differences between and within cohorts. RESULTS Higher HIV testing rates for enrollees with schizophrenia were associated with higher state-level Medicaid spending per enrollee, efforts to reduce Medicaid fragmentation, and higher federal prevention funding. State-level AIDS epidemiology predicted more frequent HIV testing for enrollees with schizophrenia versus controls. Living in rural settings predicted lower HIV testing, especially for people with schizophrenia. CONCLUSION Overall, state-level predictors of HIV testing rates varied among Medicaid enrollees, although rates were generally higher for those with schizophrenia than controls. Increased HIV testing for people with schizophrenia was associated with coverage of HIV testing when medically necessary, higher Centers for Disease Control and Prevention prevention funding, and higher AIDS incidence, prevalence, and mortality when compared with controls. This analysis suggests that state policymaking has an important role to play in advancing that effort. Overcoming fragmented care systems, sustaining robust prevention funding, and consolidating funding streams in innovative and flexible ways to support more comprehensive systems of care delivery deserve attention.
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Affiliation(s)
- Marilyn D. Thomas
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine 550 16th St 2 floor, San Francisco, CA 94158
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine 675 18th St, San Francisco, CA 94107
| | - Eric Vittinghoff
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine 550 16th St 2 floor, San Francisco, CA 94158
| | - Kimberly A. Koester
- Department of Medicine, University of California San Francisco, School of Medicine 533 Parnassus Ave, San Francisco, CA 94143
| | - Priya Dahiya
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine 675 18th St, San Francisco, CA 94107
| | - Nicholas S. Riano
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine 675 18th St, San Francisco, CA 94107
- Department of Psychological Science, School of Social Ecology, University of California Irvine, 2220 Social and Behavioral Sciences Gateway, 214 Pereira Dr, Irvine, CA 92617
| | - Francine Cournos
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons 630 W 168th St, New York, NY 10032
- Department of Epidemiology, Columbia University Mailman School of Public Health 722 W 168th St, New York, NY 10032
| | - Lindsey Dawson
- KFF (Kaiser Family Foundation) 185 Berry St #2000, San Francisco, CA 94107
| | - Mark Olfson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons 630 W 168th St, New York, NY 10032
- Department of Epidemiology, Columbia University Mailman School of Public Health 722 W 168th St, New York, NY 10032
- New York State Psychiatric Institute 1051 Riverside Dr, New York, NY 10032
| | - Debra A. Pinals
- Department of Psychiatry, University of Michigan Medical School 1500 E Medical Center Dr, Ann Arbor, MI 48109
| | - Steven Crystal
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University 112 Paterson St, New Brunswick, NJ 08901
| | - James Walkup
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University 112 Paterson St, New Brunswick, NJ 08901
- Graduate School of Applied and Professional Psychology, Rutgers University 152 Frelinghuysen Rd, Piscataway, NJ 08854
| | - Starley Shade
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine 550 16th St 2 floor, San Francisco, CA 94158
| | - Christina Mangurian
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine 550 16th St 2 floor, San Francisco, CA 94158
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine 675 18th St, San Francisco, CA 94107
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital 2789 25th St, San Francisco, CA 94110
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco 490 Illinois Street 7 Floor, San Francisco, CA 94158
| | - Emily A. Arnold
- Department of Medicine, University of California San Francisco, School of Medicine 533 Parnassus Ave, San Francisco, CA 94143
- Center for AIDS Prevention Studies, University of California San Francisco 550 16th St 3rd floor, San Francisco, CA 94158
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Smith CM, Kennedy JL, Evans ME, Person MK, Haverkate R, Apostolou A. Mental Illness in Adults With HIV and HCV Infection: Indian Health Service, 2001-2020. Am J Prev Med 2022; 63:e77-e86. [PMID: 35589441 PMCID: PMC9887638 DOI: 10.1016/j.amepre.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/20/2022] [Accepted: 03/21/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Mental health disorders (MHDs) and substance use disorders (SUDs) in people living with HIV, hepatitis C virus (HCV) infection, and HIV/HCV coinfection are common and result in significant morbidity. However, there are no national prevalence estimates of these comorbidities in American Indian and Alaska Native (AI/AN) adults with HIV, HCV infection, or HIV/HCV coinfection. This study estimates the prevalence of MHD and SUD diagnoses in AI/AN adults diagnosed with HIV, HCV infection, or HIV/HCV coinfection within the Indian Health Service (IHS). METHODS In 2021, a cross-sectional study using data from the National Patient Information Reporting System was completed to identify MHD or SUD diagnoses in AI/AN adults with HIV, HCV infection, or HIV/HCV coinfection within the IHS during fiscal years 2001‒2020. Logistic regression was used to compare the odds of MHD or SUD diagnoses, adjusting for age and sex. RESULTS Of AI/AN adults diagnosed with HIV, hepatitis C virus infection, or HIV/HCV coinfection, the period prevalence of MHD or SUD diagnoses ranged from 57.2% to 81.1%. Adjusting for age and sex, individuals with HCV infection had higher odds of receiving a MHD diagnosis (AOR=1.57; 95% CI=1.47, 1.68) or SUD diagnosis (AOR=3.40; 95% CI=3.18, 3.65) than those with HIV, and individuals with HIV/HCV coinfection had higher odds of receiving a MHD diagnosis (AOR=1.60; 95% CI=1.35, 1.89) or SUD diagnosis (AOR=2.81; 95% CI=2.32, 3.41) than those with HIV. CONCLUSIONS MHD and SUD diagnoses were common in AI/AN adults diagnosed with HIV, HCV infection, or HIV/HCV coinfection, highlighting the need for culturally appropriate screening and treatment programs sensitive to the diverse strengths of AI/AN populations and structural challenges they endure.
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Affiliation(s)
- Colin M Smith
- Department of Medicine, Duke University Medical Center, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina; Indian Health Service, Rockville, Maryland.
| | - Jordan L Kennedy
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E Evans
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marissa K Person
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
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Bunting SR, Hazra A, Sheth NK. Psychiatrists as prescribers of HIV pre-exposure prophylaxis: An untapped resource for HIV prevention among patients living with mental illness. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2020.1855007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Samuel R. Bunting
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Aniruddha Hazra
- Section of Infectious Diseases and Global Health Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Neeral K. Sheth
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
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Sanders N, Miller B, Hernandez-Morales M, McEvoy J. Knowledge of HIV and HPV Among Women With Serious Mental Illness. Psychiatr Serv 2020; 71:875. [PMID: 32741339 DOI: 10.1176/appi.ps.201900618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Natalie Sanders
- Medical College of Georgia at Augusta University, Augusta (Sanders, Hernandez-Morales); Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta (Miller, McEvoy)
| | - Brian Miller
- Medical College of Georgia at Augusta University, Augusta (Sanders, Hernandez-Morales); Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta (Miller, McEvoy)
| | - Maytte Hernandez-Morales
- Medical College of Georgia at Augusta University, Augusta (Sanders, Hernandez-Morales); Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta (Miller, McEvoy)
| | - Joseph McEvoy
- Medical College of Georgia at Augusta University, Augusta (Sanders, Hernandez-Morales); Department of Psychiatry and Health Behavior, Medical College of Georgia at Augusta University, Augusta (Miller, McEvoy)
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Ayano G, Haile K, Tesfaye A, Haile K, Demelash S, Tulu M, Tsegaye B, Solomon M, Kebede A, Biru A, Birhanu H, Zenawi G, Habtamu Y, Kibron E, Eshetu S, Sefiw M, Assefa D, Yohannes Z. Undiagnosed HIV, hepatitis B, and hepatitis C infections in people with severe psychiatric disorders in Ethiopia. BMC Infect Dis 2020; 20:180. [PMID: 32106864 PMCID: PMC7045486 DOI: 10.1186/s12879-020-4907-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 02/19/2020] [Indexed: 12/29/2022] Open
Abstract
Background Worldwide, there is limited epidemiologic evidence on the seroprevalence of undiagnosed chronic viral infections including HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among patients with severe psychiatric disorders. To our knowledge, this is the first study to explore and compare undiagnosed seroprevalence rates of HIV, HBV, and HCV infections among patients with severe psychiatric disorders. Method In this study, we included a random sample of 309 patients with severe psychiatric disorders selected by systematic sampling technique. We used a structured clinical interview for DSM-IV (SCID) to confirm the diagnosis of severe psychiatric disorders among the participants. Binary and multivariable logistic regression models, adjusting for the potential confounding factors was used to explore the potential determinants of chronic viral infections. Result The prevalence estimates of HIV infection among patients with severe psychiatric disorders in this study (3.24%) was roughly 3 times the estimated population prevalence of HIV infection in Ethiopia (1.1%). This study showed that the prevalence rates of HBV and HCV infections among patients with severe psychiatric disorders were 4.85 and 1.29%, respectively. Our results also showed that among patients with chronic viral infections, HIV, HBV and HCV, 76.92, 60, 80, and 75% respectively were undiagnosed. Regarding associated factors, the presence of chronic viral infection was found to be significantly associated with the age of the participants (ranging between 30 and 40 years) after adjusting for the possible confounding factors [AOR = 3.95 (95%CI.18–13.17)]. Conclusion Even though the prevalence estimates of HIV (3.24%), HBV (4.85%), and HCV (1.29%) infections were high among patients with severe psychiatric disorders, the majority of them remained undiagnosed. HBV was found to be the commonly undiagnosed infection (4 out of 5) followed by HCV (3 out of 4) and HIV (6 out of 10). The present study provided evidence of a significant association between the age of the participant (between 30 and 40 years) and chronic viral infections in patients with severe psychiatric disorders. Increasing the awareness of psychiatry professionals and early screening, as well as interventions of chronic viral infections among patients with severe psychiatric disorders are imperative.
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Affiliation(s)
- Getinet Ayano
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia. .,School of Public Health, Curtin University, Perth, Westen Australia, Australia.
| | - Kibrom Haile
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Abel Tesfaye
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia.,Department of medicine, Hawassa University, Hawassa, Ethiopia
| | - Kelemua Haile
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | | | - Mikias Tulu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Belachew Tsegaye
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Melat Solomon
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Alem Kebede
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Aynalem Biru
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Habte Birhanu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Gebresilassie Zenawi
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Yodit Habtamu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Esias Kibron
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Seneshet Eshetu
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Meseret Sefiw
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Dawit Assefa
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
| | - Zegeye Yohannes
- Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia
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Abas M, O'Cleirigh C. Global mental health and the ambition to end AIDS by 2030. Lancet Psychiatry 2018; 5:867-869. [PMID: 30314854 DOI: 10.1016/s2215-0366(18)30385-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Melanie Abas
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Conall O'Cleirigh
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Social exclusion and human rights at the intersection of HIV and severe mental illness - Author's Reply. Lancet Psychiatry 2017; 4:899. [PMID: 29179927 DOI: 10.1016/s2215-0366(17)30439-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 10/18/2017] [Indexed: 11/23/2022]
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Hodson N, Bewley S. Social exclusion and human rights at the intersection of HIV and severe mental illness. Lancet Psychiatry 2017; 4:898-899. [PMID: 29179926 DOI: 10.1016/s2215-0366(17)30438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Nathan Hodson
- Department of Anaesthetics, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, UK.
| | - Susan Bewley
- Department of Women and Children's Health, King's College London, 10th Floor, North Wing, St Thomas' Hospital, London SE1 7EH, UK
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