title: Hepatitis C among patients with mental illness in Brazil: an analysis of associated factors.
abstract: OBJECTIVE
  The objective was to assess factors associated with previous exposure to hepatitis C virus (HCV) infection among Brazilian adults in mental health centers.
  
  
  METHODS
  A cross-sectional national multicenter study of 2087 psychiatric patients randomly selected from 26 public mental health services was conducted between 2005 and 2007 in Brazil. An interview was conducted for obtaining sociodemographic, clinical and behavioral data. Psychiatric diagnoses were obtained from medical charts. Serology testing was conducted using anti-HCV. The magnitude of the associations was estimated by the prevalence rate ratio under Poisson distribution. Multivariate analysis for previous HCV exposure was carried out by weighted Poisson regression.
  
  
  RESULTS
  The weighted prevalence of previous HCV exposure was 2.53% (95% confidence interval: 2.22-2.83). Factors associated with previous exposure to HCV infection included male gender; age ≥ 40 years; history of sexually transmitted infections; current tobacco use; lifetime injecting drug use; exchange of money/drugs for sex; and main psychiatric diagnoses of psychoses and bipolar disorders, substance use disorders or dementia.
  
  
  CONCLUSIONS
  Our results indicate a high prevalence of previous exposure to HCV in this population of Brazilian psychiatric patients. Most factors statistically associated with HCV were demographic or behavioral related, indicating a potential high-vulnerability profile. Screening for HCV in high-risk patients should be routine practices in these mental health services in Brazil.
authors.affiliation: Infectious Diseases Reference Center CTR-DIP Orestes Diniz, Municipal Health Division/Federal University of Minas Gerais, Belo Horizonte, Brazil. ricardocarmo.bhz@gmail.com
authors.forename: Ricardo Andrade
authors.initials: RA
authors.lastname: Carmo
authors.forename: Lorenza Nogueira
authors.initials: LN
authors.lastname: Campos
authors.forename: Ana Paula Souto
authors.initials: AP
authors.lastname: Melo
authors.forename: Mark Drew Crosland
authors.initials: MD
authors.lastname: Guimarães
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity; D016174:Hepacivirus; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008605:Mental Health Services; D036301:Qualitative Research
chemical_list: D018937:Hepatitis C Antibodies