Systematic Screening for Hepatitis B, C, and HIV and Linkage to Care in Patients With Mental Health Disorders Admitted to the Emergency Department

Abstract

People with mental health disorders have a significant lack of physical health care. They also have higher rates of medical co-morbidity. The aim of this study was to assess the feasibility and the linkage to care of systematic screening for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in patients admitted for an acute psychiatric event at the emergency department (ED). This was an observational prospective cohort study for 1 year. Systematic screening was performed for HBV, HCV and HIV for all adult patients presenting to the ED for acute psychiatric reasons. This was a collaborative work between 3 departments (emergency, hepatology and psychiatry). A total of 584 patients were included. The median age was 42 years (range 29–56) with 304 (52%) men. Among all study patients, 50% were hospitalised in the psychiatry ward, and 38 (7%) had a positive serological screening, including 9 (2%), 19 (3%) and 12 (2%), respectively, for HBV, HCV and HIV. Among 19 patients with HCV, 12 had negative HCV RNA, 2 were treated and cured, and 5 were lost to follow-up. This study demonstrated the feasibility of HBV, HCV and HIV screening and linkage to care programmes in people with mental health disorders in the ED. The medical importance for this at-risk population confirms the significant benefit of continuing this screening in hospitals or as outpatients.