HEPATITIS-C VIRUS-INFECTION AMONG INSTITUTIONALIZED PSYCHIATRIC-PATIENTS - A REGRESSION-ANALYSIS OF INDICATORS OF RISK

Background/Aims: Institutionalised psychiatric patients are at increas ed risk of developing chronic infection with hepatitis B virus (HBV), However, little information is available on transmission and epidemiol ogy of hepatitis C virus (HCV) in this setting, The aim of this study was to identify potential risk factors of acquiring HCV infection in t wo large psychiatric institutions in northern Italy, Methods: We desig ned a case-control study using randomly selected controls from the sam e study database, consisting of a total of 1180 patients, in order to satisfy the principle that both cases and controls should be represent ative of the same base experience, A multiple regression logistic anal ysis was used to identify features that could predict exposure to HCV as evidenced by the presence of circulating anti-HCV antibodies, Resul ts: Anti-HCV was detected in 79 patients (6.7%), The prevalence of vir aemia and the distribution of genotypes were very similar to those fou nd in subjects with chronic HCV infection drawn from the same geograph ical area, Multivariate analysis indicated that a diagnosis of psychos is and a history of trauma were statistically significant independent risk factors associated with a positive anti-HCV result (OR 2.615, 1.2 73-5.373 95% CI and OR 2.096, 1.133-3.877 95% CI, respectively), Concl usions: The findings of this large epidemiological study show for the first time that prolonged residence in psychiatric institutions does n ot entail per se a 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 b e adequate to prevent infection.