2023-10-09 15:31:06
In Europe, the prevalence of HCV among people with mental disorders is approximately 10 times higher than among the general population, partly due to factors such as drug use, history of incarceration, and modes of transmission. atypical conditions linked to institutional promiscuity. A recent study carried out at CH le Vinatier supports a systematic screening strategy for this population.
HCV affects between 0.5% and 2% of the general population, causing progressive liver damage and other complications. The introduction of direct-acting antivirals has significantly improved treatment, with efficacy now approaching 100%. This has led to the global goal of eliminating HCV as a public health threat by 2030, requiring a significant reduction in new infections and mortality.
People who inject drugs, prisoners and men who have sex with men are particularly vulnerable to HCV infection. Additionally, people with mental health disorders (PMD) are also at increased risk of chronic HCV infection. In Europe, the prevalence of HCV among PTM is approximately 10 times higher than in the general population, partly due to factors such as drug use, history of incarceration, and atypical modes of transmission linked to institutional promiscuity.
Le Vinatier, second largest French psychiatric hospital (with more than 5,000 stays each year) conducted a study over three consecutive years. This study analyzed data from more than 16,000 stays, during which 2,540 patients were tested for HCV serology, with 55 positive tests. Of these patients, 48 underwent viral load counting, of which 15 tested positive. This represents approximately 0.59% of all patients tested for HCV serology.
Among patients with positive viral loads, almost half had already been treated for HCV. Negative correlations were observed between a positive viral load and a history of illicit drug use or incarceration. This suggests that individuals with a clear history of risk are more likely to have been identified and treated previously, leaving those without apparent risk factors undiagnosed.
The results of this study highlight the importance of routine HCV screening in patients with mental disorders, even in the absence of apparent risk factors. To achieve the goal of eliminating HCV by 2030, it is crucial to detect active infections, even in patients without a clear history of risk.
The case-control study carried out at the Vinatier psychiatric hospital provided essential information on the prevalence of HCV and the factors associated with a positive viral load in patients with mental disorders. These results call for a more systematic screening approach to effectively combat HCV, while highlighting the complexity of this disease in vulnerable populations.
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*Case-control studies are observational, analytical, etiological epidemiological studies whose principle consists of comparing the frequency of past exposure to one or more exposure factors (or potential risk factors) between 2 groups of subjects, that made up of individuals suffering from the disease studied, the group of “cases”, and that made up of subjects free of the disease studied, the group of “controls”
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