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

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.