Chronic hepatitis B and C in patients with mental illnesses: clinical and epidemiological aspects

Objective. To study the clinical and epidemiological features of chronic hepatitides and cirrhosis of HBV and HCV etiology in patients with different mental illnesses. Subjects and methods. Examinations were made in seventy 18-70-year-old patients with mental illnesses and chronic hepatitis B (CHB) and C (CHC). Results. Middle-aged people suffered from CHB and CHC, whereas elderly people had viral cirrhosis. HBV infection occurred more frequently by sexual and artificial routes; HCV did by intravenous drug use or promiscuity. HBe-negative CHB constituted the highest proportion (45.7%) among hepatitides; CHC (41.4%) and CHB + CHC (5.7%) were less common. The clinical presentation in CHB was characterized by a preponderance of asthenia, dyspepsia, liver pain, minimal cytolysis, and cholestasis. Patients with CHB, CHC, or CHB + CHC were found to have grades 2 and 3 liver fibrosis (F2-F3) in 34.3, 48.3, and 25% of cases, respectively. In 7.2% of cases, the outcomes of chronic hepatitides were viral cirrhosis of HBV-, HCV-, and HBV + HCV etiologies with more clear-cut symptoms: severe asthenia, portal hypertension, encephalopathy, liver cell failure, hepatosplenomegaly, mild cytolysis, and severe cholestasis, which made it difficult to perform psychopharmacotherapy. There was a direct correlation of the activity of CHB, CHC, and viral cirrhosis with the severity of schizophrenia (p < 0.05). Conclusion. In patients with mental illnesses, CHB and CHC have an adverse effect on the course and severity of mental illness (schizophrenia). There were differences in the course of CHB, CHC, and CHB + CHC and viral cirrhosis in these patients.

mental illnesses, chronic hepatitis B and C