PMID- 28687481
OWN - NLM
STAT- In-Data-Review
LR  - 20180502
IS  - 2215-0374 (Electronic)
IS  - 2215-0366 (Linking)
VI  - 4
IP  - 9
DP  - 2017 Sep
TI  - Prevalence and risk factors for HIV, hepatitis B, and hepatitis C in people with 
      severe mental illness: a total population study of Sweden.
PG  - 685-693
LID - S2215-0366(17)30253-5 [pii]
LID - 10.1016/S2215-0366(17)30253-5 [doi]
AB  - BACKGROUND: Severe mental illness is associated with increased morbidity and
      mortality. The elevated risk of blood-borne viruses (BBVs) in people with severe 
      mental illness is of concern, but the full extent of this problem is unclear. We 
      aimed to determine the prevalence of and risk factors for BBVs in people with
      severe mental illness. METHODS: In this nationwide, population-based,
      cross-sectional study, we estimated the point prevalence of HIV, hepatitis B
      (HBV), and hepatitis C (HCV) in people with severe mental illness, including the 
      total adult (>/=18 years) Swedish population. We defined severe mental illness as
      a clinical diagnosis of schizophrenia, schizoaffective disorder, bipolar
      disorder, or other psychotic illness according to the Swedish version of the
      International Statistical Classification of Diseases version 8, 9, or 10. We used
      multivariable logistic regression to determine the odds of BBVs in individuals
      with severe mental illness, relative to the general population, and to identify
      independent risk factors (age, sex, immigration status, socioeconomic status,
      education, and substance misuse) for BBV infection. We also did a sensitivity
      analysis excluding BBV diagnoses made before the introduction of the Register for
      Infection Disease Control (1997). FINDINGS: Of 6 815 931 adults in Sweden, 97 797
      (1.43%) individuals had a diagnosis of severe mental illness. Prevalence of BBVs 
      was elevated in people with severe mental illness, of which 230 (0.24%) had HIV, 
      518 (0.53%) had HBV, and 4476 (4.58%) had HCV. After accounting for
      sociodemographic characteristics, the odds of HIV were 2.57 (95% CI 2.25-2.94,
      p<0.0001) times higher in people with severe mental illness than in the general
      population, whereas the odds of HBV were 2.29 (2.09-2.51, p<0.0001) times higher 
      and the odds of HCV were 6.18 (5.98-6.39, p<0.0001) times higher. Substance
      misuse contributed most to the increased risk of BBV: after adjustment, odds
      ratios were 1.61 (1.40-1.85, p<0.0001) for HIV, 1.28 (1.16-1.41, p<0.0001) for
      HBV, and 1.72 (1.67-1.78, p<0.0001) for HCV. INTERPRETATION: Our results
      highlight the need to address the issue of higher prevalence of BBVs in people
      with severe mental illness and identify interventions preventing infection.
      Targeting of comorbid substance misuse would have particular effect on reduction 
      of BBV prevalence in this population. FUNDING: Medical Research Council and
      Swedish Research Council.
CI  - Copyright (c) 2017 The Author(s). Published by Elsevier Ltd. This is an Open
      Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All
      rights reserved.
FAU - Bauer-Staeb, Clarissa
AU  - Bauer-Staeb C
AD  - Division of Psychiatry, University College London, London, UK.
FAU - Jorgensen, Lena
AU  - Jorgensen L
AD  - Division of Public Health Epidemiology, Department of Public Health Sciences,
      Karolinska Institutet, Stockholm, Sweden.
FAU - Lewis, Glyn
AU  - Lewis G
AD  - Division of Psychiatry, University College London, London, UK.
FAU - Dalman, Christina
AU  - Dalman C
AD  - Division of Public Health Epidemiology, Department of Public Health Sciences,
      Karolinska Institutet, Stockholm, Sweden.
FAU - Osborn, David P J
AU  - Osborn DPJ
AD  - Division of Psychiatry, University College London, London, UK.
FAU - Hayes, Joseph F
AU  - Hayes JF
AD  - Division of Psychiatry, University College London, London, UK. Electronic
      address: joseph.hayes@ucl.ac.uk.
LA  - eng
GR  - MR/K021362/1/Medical Research Council/United Kingdom
PT  - Journal Article
DEP - 20170704
PL  - England
TA  - Lancet Psychiatry
JT  - The lancet. Psychiatry
JID - 101638123
PMC - PMC5573766
EDAT- 2017/07/09 06:00
MHDA- 2017/07/09 06:00
CRDT- 2017/07/09 06:00
PHST- 2017/03/02 00:00 [received]
PHST- 2017/05/23 00:00 [revised]
PHST- 2017/05/25 00:00 [accepted]
PHST- 2017/07/09 06:00 [pubmed]
PHST- 2017/07/09 06:00 [medline]
PHST- 2017/07/09 06:00 [entrez]
AID - S2215-0366(17)30253-5 [pii]
AID - 10.1016/S2215-0366(17)30253-5 [doi]
PST - ppublish
SO  - Lancet Psychiatry. 2017 Sep;4(9):685-693. doi: 10.1016/S2215-0366(17)30253-5.
      Epub 2017 Jul 4.