HEPATITIS-C AND HEPATITIS-B SEROPREVALENC E IN PATIENTS INFECTED WITHTHE 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 f rom five psychiatric hospitals in the Ile de France region. To this en d, 117 HIV infected patients benefited from : a) a screening program f or HCV, HBV, and syphilis antibodies and b) a dosage of transaminases. The associated risk factors were as follows: 64 % of HIV infected pat ients were drug addicts, 12 % were heterosexuals, 10 % were homosexual s, and 3 % had received a blood transfusion. The precise means of cont amination was not established in 11 % of the cases. The prevalence of HIV was 71 % but varied according to the means of contamination. No co rrelation was found between HCV seropositivity and an increased level of transaminases, 80 % of patients were carriers of at least one hepat itis B marker antibody. The detection of the sole HBc antibody, in the absence of other HBV markers, appeared to be a good indirect marker o f hepatitis C. Only 3 % of the patients were screened as responding we ll to vaccination against hepatitis B (isolated Ac HBs). 6 % of the pa tients were contaminated by all three viruses, HIV, HCV, and HBV. This study is the first to show, within the psychiatric sphere, that the p revalence of hepatitis C is considerably higher for HIV infected patie nts. Contamination through intravenous injection of drugs is the most likely cause of infection. A prospective follow up of HIV infected pat ients 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.