Hepatitis C and B seroprevalence in patients infected with the human immunodeficiency virus in psychiatric hospitals

The aim of this retrospective study, carried out between January 1992 and April 1995 was to determine the prevalence and characteristics of infection by the hepatitis C virus for a population of HIV+ patients from five psychiatric hospitals in the Ile de France region. To this end, 117 HIV infected patients benefited from : a) a screening program for HCV, HBV, and syphilis antibodies and b) a dosage of transaminases. The associated risk factors were as follows: 64 % of HIV infected patients were drug addicts, 12 % were heterosexuals, 10 % were homosexuals, and 3 % had received a blood transfusion. The precise means of contamination was not established in 11 % of the cases. The prevalence of HIV was 71 % but varied according to the means of contamination. No correlation was found between HCV seropositivity and an increased level of transaminases, 80 % of patients were carriers of at least one hepatitis B marker antibody. The detection of the sole HBc antibody, in the absence of other HBV markers, appeared to be a good indirect marker of hepatitis C. Only 3 % of the patients were screened as responding well to vaccination against hepatitis B (isolated Ac HBs). 6 % of the patients were contaminated by all three viruses, HIV, HCV, and HBV. This study is the first to show, within the psychiatric sphere, that the prevalence of hepatitis C is considerably higher for HIV infected patients. Contamination through intravenous injection of drugs is the most likely cause of infection. A prospective follow up of HIV infected patients is therefore indispensable. Finally, the insufficient number of patients vaccinated against the hepatitis B virus should incite us to relaunch a vaccination programme in our hospital centers.