Rates of hepatitis B and C in patients with schizophrenia: A meta-analysis

Emily Lluch, Brian J. Miller

Research output: Contribution to journalReview article

Abstract

Objective: Schizophrenia is associated with increased infectious disease comorbidity and mortality. Individuals with schizophrenia have increased risk of infectious hepatitis, potentially due to substance use comorbidity, sexual behaviors, and immunologic factors. We performed a systematic review and meta-analysis of the association between schizophrenia and hepatitis B and C. Method: We searched major electronic databases from inception until January 2019 for prevalence and case-control studies of infectious hepatitis in patients with schizophrenia. Random effects meta-analyses calculating odds ratios (ORs) and 95% confidence intervals (CIs) for case-controls studies, prevalence and 95% CIs, and meta-regression analyses were performed. Results: Twenty-one studies met the inclusion criteria. In case-control studies, there was an over 3-fold increased odds of hepatitis C in patients with schizophrenia (OR = 3.29, 95% CI 1.50–7.23, p = 0.003), and a prevalence of 6% (ES = 0.06, 95% CI 0.04–0.08). In case-control studies, there was an over 2-fold increased odds of hepatitis B in patients with schizophrenia (OR = 2.36, 95% CI 1.61–3.47, p < 0.001) and a prevalence of 7% (ES = 0.07, 95% CI 0.03–0.11). Conclusion: We found an approximately 3-fold increased odds of hepatitis B and C in patients with schizophrenia. This association may be due to an increased prevalence of environmental risk factors, increased susceptibility to infections, or both. Findings suggest that screening for infectious hepatitis may be germane to the clinical care of patients with schizophrenia and relevant risk factors.

Original languageEnglish (US)
Pages (from-to)41-46
Number of pages6
JournalGeneral Hospital Psychiatry
Volume61
DOIs
StatePublished - Nov 1 2019

Fingerprint

Hepatitis C
Hepatitis B
Meta-Analysis
Schizophrenia
Confidence Intervals
Hepatitis A
Case-Control Studies
Odds Ratio
Comorbidity
Immunologic Factors
Sexual Behavior
Communicable Diseases
Patient Care
Regression Analysis
Databases
Mortality
Infection

Keywords

  • Hepatitis
  • Infection
  • Meta-analysis
  • Psychosis
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Rates of hepatitis B and C in patients with schizophrenia : A meta-analysis. / Lluch, Emily; Miller, Brian J.

In: General Hospital Psychiatry, Vol. 61, 01.11.2019, p. 41-46.

Research output: Contribution to journalReview article

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abstract = "Objective: Schizophrenia is associated with increased infectious disease comorbidity and mortality. Individuals with schizophrenia have increased risk of infectious hepatitis, potentially due to substance use comorbidity, sexual behaviors, and immunologic factors. We performed a systematic review and meta-analysis of the association between schizophrenia and hepatitis B and C. Method: We searched major electronic databases from inception until January 2019 for prevalence and case-control studies of infectious hepatitis in patients with schizophrenia. Random effects meta-analyses calculating odds ratios (ORs) and 95{\%} confidence intervals (CIs) for case-controls studies, prevalence and 95{\%} CIs, and meta-regression analyses were performed. Results: Twenty-one studies met the inclusion criteria. In case-control studies, there was an over 3-fold increased odds of hepatitis C in patients with schizophrenia (OR = 3.29, 95{\%} CI 1.50–7.23, p = 0.003), and a prevalence of 6{\%} (ES = 0.06, 95{\%} CI 0.04–0.08). In case-control studies, there was an over 2-fold increased odds of hepatitis B in patients with schizophrenia (OR = 2.36, 95{\%} CI 1.61–3.47, p < 0.001) and a prevalence of 7{\%} (ES = 0.07, 95{\%} CI 0.03–0.11). Conclusion: We found an approximately 3-fold increased odds of hepatitis B and C in patients with schizophrenia. This association may be due to an increased prevalence of environmental risk factors, increased susceptibility to infections, or both. Findings suggest that screening for infectious hepatitis may be germane to the clinical care of patients with schizophrenia and relevant risk factors.",
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N2 - Objective: Schizophrenia is associated with increased infectious disease comorbidity and mortality. Individuals with schizophrenia have increased risk of infectious hepatitis, potentially due to substance use comorbidity, sexual behaviors, and immunologic factors. We performed a systematic review and meta-analysis of the association between schizophrenia and hepatitis B and C. Method: We searched major electronic databases from inception until January 2019 for prevalence and case-control studies of infectious hepatitis in patients with schizophrenia. Random effects meta-analyses calculating odds ratios (ORs) and 95% confidence intervals (CIs) for case-controls studies, prevalence and 95% CIs, and meta-regression analyses were performed. Results: Twenty-one studies met the inclusion criteria. In case-control studies, there was an over 3-fold increased odds of hepatitis C in patients with schizophrenia (OR = 3.29, 95% CI 1.50–7.23, p = 0.003), and a prevalence of 6% (ES = 0.06, 95% CI 0.04–0.08). In case-control studies, there was an over 2-fold increased odds of hepatitis B in patients with schizophrenia (OR = 2.36, 95% CI 1.61–3.47, p < 0.001) and a prevalence of 7% (ES = 0.07, 95% CI 0.03–0.11). Conclusion: We found an approximately 3-fold increased odds of hepatitis B and C in patients with schizophrenia. This association may be due to an increased prevalence of environmental risk factors, increased susceptibility to infections, or both. Findings suggest that screening for infectious hepatitis may be germane to the clinical care of patients with schizophrenia and relevant risk factors.

AB - Objective: Schizophrenia is associated with increased infectious disease comorbidity and mortality. Individuals with schizophrenia have increased risk of infectious hepatitis, potentially due to substance use comorbidity, sexual behaviors, and immunologic factors. We performed a systematic review and meta-analysis of the association between schizophrenia and hepatitis B and C. Method: We searched major electronic databases from inception until January 2019 for prevalence and case-control studies of infectious hepatitis in patients with schizophrenia. Random effects meta-analyses calculating odds ratios (ORs) and 95% confidence intervals (CIs) for case-controls studies, prevalence and 95% CIs, and meta-regression analyses were performed. Results: Twenty-one studies met the inclusion criteria. In case-control studies, there was an over 3-fold increased odds of hepatitis C in patients with schizophrenia (OR = 3.29, 95% CI 1.50–7.23, p = 0.003), and a prevalence of 6% (ES = 0.06, 95% CI 0.04–0.08). In case-control studies, there was an over 2-fold increased odds of hepatitis B in patients with schizophrenia (OR = 2.36, 95% CI 1.61–3.47, p < 0.001) and a prevalence of 7% (ES = 0.07, 95% CI 0.03–0.11). Conclusion: We found an approximately 3-fold increased odds of hepatitis B and C in patients with schizophrenia. This association may be due to an increased prevalence of environmental risk factors, increased susceptibility to infections, or both. Findings suggest that screening for infectious hepatitis may be germane to the clinical care of patients with schizophrenia and relevant risk factors.

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