Management of Hepatitis C in Psychiatric Settings: Review of The Literature and Review of Experiences Over 4 Years in A Psychiatric Hospital.

Abstract

Introduction: Hepatitis C is a more common infection in the psychiatric population and psychiatric comorbidities are more common in patients with chronic viral hepatitis C. No prospective studies on hepatitis C management in a psychiatric setting in France had not been yet published. Objectives: 1/ to make a short review of the literature 2/ To determine the prevalence of HCV in the psychiatric inpatient population, to assess the feasibility of the simplified care pathway recommended by HAS and to improve the screening and management of hepatitis C in closed psychiatric settings. Methods: Collecting prospective and retrospective data on the management of hepatitis C from 2017 to 2020 among the psychiatric hospital’s incoming population. Results: Current data on the prevalence and management of hepatitis C in psychiatric settings are insufficient. In our study, the number of serologies performed among entrants increased from 2016 to 2020 with coverage of screening from 24% to 100%. In 2020, a C viral load was achieved in all patients with positive C serology. All patients with a positive viral load were assessed for fibrosis with FIBROSCAN on-site and treated with direct antivirals except 2. Conclusion: our original approach to HCV has been efficient. This cooperation between organized caregivers (hepatology mobile team and medical biology laboratory) has increased rate of screening and management of HCV in psychiatric hospitals. Hospitalization and/or psychiatric follow-up is a risk factor for hepatitis C and should lead to hepatitis screening. Larger prospective studies are needed.