2014 Articles

Correlates of hepatitis B among patients with mental illness in Brazil

Carmo, Ricardo Andrade; Melo, Ana Paula Souto; Dezanet, Lorenza Nogueira Campos; Cournos, Francine; Guimarães, Mark Drew Crosland

Objective: To assess correlates of hepatitis B among adults with mental illness under care in Brazil.
Method: Cross-sectional national multicenter study of 2206 patients with mental illnesses randomly selected from 26 public mental health services. Sociodemographic and behavioral data were obtained from face-to-face interviews and psychiatric diagnoses from medical charts. Serology testing was conducted, and prevalence rate ratios were estimated by log-binomial regression.
Results: The weighted prevalence rates of current hepatitis B virus (HBV) infection (HBsAg +) and previous HBV exposure (anti-HBc +) were 2.0% [95% confidence interval (CI): 1.5%–2.7%] and 17.1% (95% CI: 16.0%–19.0%), respectively. Correlates of HBsAg + included male gender, younger age (18–29 years), unstable place of residence, intellectual disability, main psychiatric diagnosis of dementia, presence of other medical comorbitidy, use of alcohol/drugs during sex, more than one sexual partner and use of cocaine. Correlates of anti-HBc + included male gender, older age (≥ 30 years), black skin color, lower education, unstable place of residence, currently hospitalized, intellectual disability, history of any sexually transmitted disease or syphilis, poor HIV knowledge, history of imprisonment and sexual violence.
Conclusions: Hepatitis B is an important comorbidity among psychiatric patients in Brazil. Screening for HBV, effective prevention and intervention strategies, including universal HBV immunization, should be routine practices in these mental health services.