Hepatitis C virus infection among institutionalised psychiatric patients: A regression analysis of indicators of risk

Agostino Cividini, Angela Pistorio, Angelo Regazzetti, Antonella Cerino, Carmine Tinelli, Anna Mancuso, Massimo Ribola, Maria Laura Galli, Antonio Agnusdei, Manuela Leone, Enrico Silini, Mario U. Mondelli

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Background/Aims: Institutionalised psychiatric patients are at increased risk of developing chronic infection with hepatitis B virus (HBV). However, little information is available on transmission and epidemiology of hepatitis C virus (HCV) in this setting. The aim of this study was to identify potential risk factors of acquiring HCV infection in two large psychiatric institutions in northern Italy. Methods: We designed a case- control study using randomly selected controls from the same study database, consisting of a total of 1180 patients, in order to satisfy the principle that both cases and controls should be representative of the same base experience. A multiple regression logistic analysis was used to identify features that could predict exposure to HCV as evidenced by the presence of circulating anti-HCV antibodies. Results: Anti-HCV was detected in 79 patients (6.7%). The prevalence of viraemia and the distribution of genotypes were very similar to those found in subjects with chronic HCV infection drawn from the same geographical area. Multivariate analysis indicated that a diagnosis of psychosis and a history of trauma were statistically significant independent risk factors associated with a positive anti-HCV result (OR 2.615, 1.273-5.373 95% CI and OR 2.096, 1.133- 3.877 95% CI, respectively). Conclusions: The findings of this large epidemiological study show for the first time that prolonged residence in psychiatric institutions does not entail per sea significant risk of acquiring HCV infection. Since transmission of HCV in this setting appears to occur predominantly via classical parenteral routes, simple prophylactic measures appear to be adequate to prevent infection.

Original languageEnglish
Pages (from-to)455-463
Number of pages9
JournalJournal of Hepatology
Issue number3
Publication statusPublished - Sep 1997


  • Epidemiology
  • Hepatitis C virus
  • Psychiatric institutions

ASJC Scopus subject areas

  • Gastroenterology


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