Русский
Chronic hepatitis B and C in patients with mental illnesses: clinical and epidemiological aspects
DOI: https://dx.doi.org/10.18565/epidem.2020.10.2.37-44
Baramzina S.V., Bondarenko A.L., Tokareva N.V.
1) Kirov State Medical University, Ministry of Health of Russia, Kirov, Russia; 2) Academician V.M. Bekhterev Kirov Regional Clinical Mental Hospital, Kirov, Russia
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. НBe-negative CHВ 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.
Literature
1. Руководство ВОЗ по тестированию на гепатиты В и С. Женева: ВОЗ, 2018. Лицензия: CC BY-NC-SA 3.0 IGO. http://apps.Who.Int/iris/bitstream/10665/260130/1/ 9789244549988-rus.pdf [Guidelines on hepatitis B and C testing]. Zheneva: WHO, 2018. Licenziya: CC BY-NC-SA 3.0 IGO. (In Russ.). http://apps.Who.Int/iris/bitstream/10665/260130/1/9789244549988-rus.pdf 2. Психическое здоровье. Информационный бюллетень ВОЗ. Европейское региональное бюро. ВОЗ 2012. http://www.euro.who.int [Mental Health. WHO Newsletter. Regional Office for Europe]. Geneva: WHO, 2012. (In Russ.). http://www.euro.who.int 3. Saha S., Chant D., Welham J., McGrath J. A systematic review of the prevalence of schizophrenia. PLoS Med. 2005; 2(5): 141. DOI: 10.1371/journal.pmed. 0020141. 4. Carrier P., Debette-Gratien M., Girard M., Jacques J., Nubukpo P., Loustaud-Ratti V. Liver illness and psychiatric patients. Hepat. Mon. 2016; 16(12): e41564. DOI: 10.5812/hepatmon.41564 5. Hughes E., Bassi S., Gilbody S., Bland М. Prevalence of HIV, hepatitis B, and hepatitis C in people with severe mental illness: a systematic review and meta-analysis. Lancet Psychiatry 2016; 3(1): 40–8. DOI: 10.1016/S2215-0366(15)00357-0 6. Крот К.В., Мешалкина С.Ю., Слободенюк Е.В. Социально-экономическая значимость психических расстройств: региональные аспекты. Дальневосточный медицинский журнал 2016; (1): 91–6. Krot K.V., Meshalkina S.Yu., Slobodenyuk E.V. [The socio-economic importance of mental disorders: regional aspects]. Dalnevostochnyy meditsinskiy zhurnal 2016; (1): 91–6. (In Russ.). 7. Гурович И.Я., Любов Е.Б., Чапурин С.А., Чурилин Ю.Ю., Еналиев И.Р. Бремя депрессивных расстройств в отечественных психиатрических службах. Журнал неврологии и психиатрии 2010; (3): 77–82. Gurovich I.Yа., Lyubov E.B., Chapurin S.A., Churilin Yu. Yu., Enaliev I.R. [The burden of depressive disorders in domestic psychiatric services]. Zhurnal nevrologii i psihiatrii 2010; (3): 77–82. (In Russ.). 8. Тарханов В.С., Решетникова А.В., Ягупова Н.Х. Распространенность сопутствующей соматической патологии среди больных геронтопсихиатрического профиля Юга России. Врач–аспирант 2013; 58(3): 57–62. https://vrach-aspirant.ru/articles/psychiatry/13160/ Tarhanov V.S., Reshetnikova A.V., Yаgupova N.H. [The prevalence of concomitant somatic pathology among patients with a gerontopsychiatric profile in the South of Russia]. Vrach–aspirant 2013; 58(3): 57–62. (In Russ.). https://vrach-aspirant.ru/ articles/psychiatry/13160/ 9. О наркоситуации в Кировской области по итогам 2016 года. Доклад антинаркотической комиссии в Кировской области. Киров, 2017. https://gigabaza.ru/doc/75704-pall.html [On the drug situation in the Kirov Region in 2016. Report of the anti-drug commission in the Kirov Region]. Kirov, 2017. https://gigabaza.ru/doc/75704-pall.html 10. О состоянии санитарно-эпидемиологического благополучия населения в Кировской области в 2015 году. Государственный доклад. Управление Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека по Кировской области, 2016. https://www.43.rospotrebnadzor.ru/documents/gosregdoklad/publications/svoddokl2015.pdf [On the state of sanitary and epidemiological welfare of the population in the Kirov Region in 2015. State report]. Kirov, 2016. (In Russ.). https://www.43.rospotrebnadzor. ru/documents/gosregdoklad/publications/ svoddokl2015.pdf 11. Bruno S., Di Marco V., Iavarone M., Roffi L., Crosignani A., Calvaruso V, еt al. Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population. J. Hepatol. 2016; 64(6): 1217–23. doi: 10.1016/j.hep.
About the Autors
Information about the authors:
Svetlana V. Baramzina, Cand. Med. Sci., Associate Professor, Kirov State Medical University, Ministry of Health of Russia, Kirov, Russia; e-mail: sw3837@mail.ru
Prof. Alla L. Bondarenko, MD, Head, Department of Infectious Diseases, Kirov State Medical University, Ministry of Health of Russia, Kirov, Russia; e-mail: med@kirovgma.ru
Natalia V. Tokareva, Infectiologist, Academician V.M. Bekhterev Kirov Regional Clinical Mental Hospital, Kirov, Russia; e-mail: kirovpsyo@mail.ru, info@kokpb.ru
