TY - JOUR
T1 - Determinants of Hepatitis C Virus Prevalence in People with Serious Mental Illness
T2 - A Systematic Review and Meta-Analysis
AU - Braude, Michael Rudi
AU - Phan, Timothy
AU - Dev, Anouk
AU - Sievert, William
N1 - Funding Information:
All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past 3 years, Marlene P. Freeman, MD, Editor in Chief, has received research funding from JayMac and Sage; has been a member of the Independent Data Safety and Monitoring Committee for Janssen (Johnson & Johnson) and Novartis; and has served on advisory boards for Eliem and Sage. As an employee of Massachusetts General Hospital (MGH), Dr Freeman works with the MGH National Pregnancy Registry, which receives funding from Alkermes, Aurobindo, AuroMedics, Johnson & Johnson/Janssen, Otsuka, Sage, Sunovion, Supernus, and Teva, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosure appears at the end of the article.
Publisher Copyright:
© 2021 Physicians Postgraduate Press, Inc.
PY - 2022/1
Y1 - 2022/1
N2 - Objective: To perform a meta-analysis of hepatitis C virus (HCV) prevalence in people with serious mental illness (SMI) and to systematically review barriers to care with the contention that both individual complications and HCV community transmission can be reduced with enhanced health care strategies. Data Sources: PubMed, Scopus, Embase, CINAHL, and Web of Science were searched for articles published in English between April 21, 1989, and July 1, 2020. The terms Hepatitis C Virus, HCV, HCV seroprevalence, and HCV prevalence were cross-referenced with serious mental illness, severe mental illness, psychiatric illness, mental illness, and psychiatric patients. Study Selection: We identified 230 titles after removing duplicates. The final analysis included 36 publications drawn from prospective and large retrospective cohort studies that cross-sectionally screened for HCV in people with SMI ≥ 18 years of age. Data Extraction: Pooled HCV prevalence was analyzed, with random effects modeling due to significant attributable study heterogeneity. Demographic data and HCV risk factors were subanalyzed. Qualitative and semiqualitative data relating to control cohort prevalence and the HCV care cascade were also extracted. Results: The pooled HCV prevalence was 8.0% (95% CI, 6.0%–9.0%). Subanalysis of prospective studies (n = 9,015 individuals) demonstrated a similar prevalence, 8.0% (CI, 5.0%–11.0%), to retrospective studies (n = 289,247), 8.0% (CI, 6.0%–10.0%). HCV was 3.0- to 11.3-fold higher in people with SMI relative to controls. Semiqualitative analysis of seropositive cases showed that (1) 20.0%–58.1% did not have an identified HCV risk factor; (2) 12.5%–100% of cases were not previously known to have HCV; and (3) the majority, 57.0%–96.6%, of people with SMI were receptive to HCV screening. Conclusions: People with SMI have high HCV seroprevalence and should be recognized as a priority group for HCV screening and health care access.
AB - Objective: To perform a meta-analysis of hepatitis C virus (HCV) prevalence in people with serious mental illness (SMI) and to systematically review barriers to care with the contention that both individual complications and HCV community transmission can be reduced with enhanced health care strategies. Data Sources: PubMed, Scopus, Embase, CINAHL, and Web of Science were searched for articles published in English between April 21, 1989, and July 1, 2020. The terms Hepatitis C Virus, HCV, HCV seroprevalence, and HCV prevalence were cross-referenced with serious mental illness, severe mental illness, psychiatric illness, mental illness, and psychiatric patients. Study Selection: We identified 230 titles after removing duplicates. The final analysis included 36 publications drawn from prospective and large retrospective cohort studies that cross-sectionally screened for HCV in people with SMI ≥ 18 years of age. Data Extraction: Pooled HCV prevalence was analyzed, with random effects modeling due to significant attributable study heterogeneity. Demographic data and HCV risk factors were subanalyzed. Qualitative and semiqualitative data relating to control cohort prevalence and the HCV care cascade were also extracted. Results: The pooled HCV prevalence was 8.0% (95% CI, 6.0%–9.0%). Subanalysis of prospective studies (n = 9,015 individuals) demonstrated a similar prevalence, 8.0% (CI, 5.0%–11.0%), to retrospective studies (n = 289,247), 8.0% (CI, 6.0%–10.0%). HCV was 3.0- to 11.3-fold higher in people with SMI relative to controls. Semiqualitative analysis of seropositive cases showed that (1) 20.0%–58.1% did not have an identified HCV risk factor; (2) 12.5%–100% of cases were not previously known to have HCV; and (3) the majority, 57.0%–96.6%, of people with SMI were receptive to HCV screening. Conclusions: People with SMI have high HCV seroprevalence and should be recognized as a priority group for HCV screening and health care access.
UR - http://www.scopus.com/inward/record.url?scp=85136559339&partnerID=8YFLogxK
U2 - 10.4088/JCP.21r14079
DO - 10.4088/JCP.21r14079
M3 - Review Article
C2 - 34905666
AN - SCOPUS:85136559339
SN - 0160-6689
VL - 83
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 1
M1 - 21r14079
ER -
