HIV, syphilis, and hepatitis B and C prevalence among patients with mental illness: a review of the literature

Abstract

A limited number of studies worldwide have investigated the prevalence of HIV, syphilis, and hepatitis B and C infection among psychiatric patients. However, prevalence of these infections in the population with chronic mental illness has not been clearly established. Most of the published papers are from developed countries and have derived from relatively small and non-representative samples. We performed a systematic review of the published literature to identify studies on these infectious diseases within psychiatric populations in Brazil and other developing countries. Overall, prevalence rates varied from 0% to 29% for HIV; 1.6% to 66% for HBV; 0.4% to 38% for HCV; and 1.1% to 7.6% for syphilis. Several risk factors were identified and discussed, although sampling limitations restrict the generalization of study findings. This review highlights the lack of information on the prevalence of sexually transmitted diseases and their associated factors among persons with chronic mental illness and identifies gaps in the knowledge base in both developing and developed countries.

Prevalence of HIV, syphilis, hepatitis B and C among adults with mental illness: a multicenter study in Brazil

“…The point prevalence of HIV, syphilis, hepatitis B and C were shown to be higher when comparing to other Brazilian studies with probability samples of non-psychiatric populations, although some estimates were within the 95% confidence limits. Severe mental health conditions with lower perception of risk and cognitive impairment could partially explain these findings 7,19,20 . Also, lower socioeconomic conditions, lack of social support and poor access to health care may add to the burden of other medical conditions, including STI, to psychiatric patients 7,20 .…”

“…Severe mental health conditions with lower perception of risk and cognitive impairment could partially explain these findings 7,19,20 . Also, lower socioeconomic conditions, lack of social support and poor access to health care may add to the burden of other medical conditions, including STI, to psychiatric patients 7,20 . Our rates tended to be lower than those found among SMI patients in developed countries (3%-22%) 7 , particularly the USA, where studies tend to include younger and more severe mentally ill patients, usually recruited from one or a few psychiatric institutions with no clear geographical or population basis 1 .…”

“…Also, lower socioeconomic conditions, lack of social support and poor access to health care may add to the burden of other medical conditions, including STI, to psychiatric patients 7,20 . Our rates tended to be lower than those found among SMI patients in developed countries (3%-22%) 7 , particularly the USA, where studies tend to include younger and more severe mentally ill patients, usually recruited from one or a few psychiatric institutions with no clear geographical or population basis 1 . Similarly, studies carried out in Brazil among other populations may have been too specific in their age and/ or gender definitions or eligibility criteria (i.e., military recruits or pregnant women).…”

“…Studies with national representative samples have been conducted among pregnant women 3,4 , military recruits 5 , and more recently studies among men who have sex with men, female sex workers and injecting drug users (IDU) are currently under way in 10 major Brazilian metropolitan areas 6 . There is evidence that patients with mental illness have increased prevalence of STI, including HIV, with rates varying from 3% to 22% 7 . However, most of these seroprevalence studies have been conducted in developed countries among patients with severe mental illness (SMI), i.e., schizophrenia, bipolar disorders and depression with psychotic symptoms 8 , or in mental health care facilities which over represent populations with substance use disorders and IDU.…”

Incidence of Hepatitis B and C Infections in Patients of Mental Disorders

“…When the serological diagnostic tests are commonly used for hepatitis infections, the follow-up and treatment periods make a breakthrough, viral contamination ways are identified and protection methods are found to prevent transmission to more people [8].…”