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Understanding Associations Between Serious Mental Illness and Hepatitis C Virus Among Veterans: A National Multivariate Analysis

Received February 16, 2007; revised May 16, 2007; accepted May 18, 2007. From the Univ. of Maryland School of Medicine, Dept. of Psychiatry (SH,DM,RG, LD); Dept. of Veterans Affairs VISN 5, MIRECC (SH,DM,RG,LD); the Veterans Affairs Serious Mental Illness Treatment Research and Evaluation Center (JFM,DG,AK,FCB); and the Univ. of Michigan School of Medicine, Dept. of Psychiatry (JFM,AK,FCB). Send correspondence and reprint requests to Seth Himelhoch, M.D., M.P.H., VA Capital Health Care Network MIRECC, Univ. of Maryland School of Medicine, Dept. of Psychiatry, Division of Services Research, 773 W. Lombard St., Rm. 516, Baltimore, MD 21201. e-mail: shimelho{at}psych.umaryland.edu
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Hepatitis C virus (HCV) is a leading cause of hepatocellular carcinoma and cirrhosis in the United States and is known to be transmitted via pathways associated with substance use (e.g., injection drug use and intranasal drug use). OBJECTIVE: Although individuals with serious mental illness (SMI) have a high prevalence of HCV, the nature of this relationship is unclear and is the subject of this investigation. METHOD: The authors determined unadjusted and adjusted recorded prevalence of HCV among a national sample of veterans with and without SMI. RESULTS: HCV was recorded in 8.1% of patients with bipolar disorder, 7.1% of patients with schizophrenia, and 2.5% of patients without SMI. Substance use increased HCV risk among SMI patients; patients with bipolar disorder had greater risk than patients with schizophrenia. CONCLUSION: Efforts to address HCV among patients with serious mental illness and co-occurring substance abuse are warranted.

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