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Systematic Screening for Hepatitis B, C, and HIV and Linkage to Care in Patients With Mental Health Disorders
Prabakar Vaittinada Ayar1,2,3, Jamal Abdelkader4, Matthieu Gay1
1Emergency Department, Beaujon Hospital, AP-HP, Clichy, France.
Insights
Routine screening for hepatitis B, hepatitis C, and HIV in psychiatric emergency departments is feasible. This approach effectively links patients with mental health disorders to essential viral infection care.
Area of Science:
- Infectious Diseases
- Psychiatry
- Public Health
Background:
- Individuals with mental health disorders often experience disparities in physical healthcare access.
- There is a higher prevalence of medical comorbidities in this population, necessitating integrated care approaches.
Purpose of the Study:
- To evaluate the feasibility of systematic screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in patients presenting with acute psychiatric conditions.
- To assess the effectiveness of linkage to care for identified infections within an emergency department (ED) setting.
Main Methods:
- An observational prospective cohort study was conducted over one year.
- Systematic screening for HBV, HCV, and HIV was implemented for all adult patients admitted to the ED for acute psychiatric reasons.
- Collaboration between emergency, hepatology, and psychiatry departments facilitated the screening and follow-up process.
Main Results:
- A total of 584 patients were included in the study.
- 38 patients (7%) tested positive for HBV, HCV, or HIV.
- Specific positive rates included 2% for HBV, 3% for HCV, and 2% for HIV, demonstrating the prevalence of these infections in the studied population.
Conclusions:
- Systematic screening for HBV, HCV, and HIV in psychiatric EDs is feasible and facilitates linkage to care.
- Implementing such screening programs in hospitals or outpatient settings offers significant medical benefits for this at-risk population.
Abstract:
People with mental health disorders have a significant lack of physical health care. They also have higher rates of medical co-morbidity. The aim of this study was to assess the feasibility and the linkage to care of systematic screening for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in patients admitted for an acute psychiatric event at the emergency department (ED). This was an observational prospective cohort study for 1 year. Systematic screening was performed for HBV, HCV and HIV for all adult patients presenting to the ED for acute psychiatric reasons. This was a collaborative work between 3 departments (emergency, hepatology and psychiatry). A total of 584 patients were included. The median age was 42 years (range 29-56) with 304 (52%) men. Among all study patients, 50% were hospitalised in the psychiatry ward, and 38 (7%) had a positive serological screening, including 9 (2%), 19 (3%) and 12 (2%), respectively, for HBV, HCV and HIV. Among 19 patients with HCV, 12 had negative HCV RNA, 2 were treated and cured, and 5 were lost to follow-up. This study demonstrated the feasibility of HBV, HCV and HIV screening and linkage to care programmes in people with mental health disorders in the ED. The medical importance for this at-risk population confirms the significant benefit of continuing this screening in hospitals or as outpatients.
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