Ecological Association Between Chronic Hepatitis C Virus Infection And Psychosis: An Study In Colombia, 2009-2016

Background: Hepatitis C virus (HCV) infection affects approximately 180 million people worldwide. HCV infection is a leading cause of liver disease including hepatitis, cirrhosis and hepatocellular carcinoma, but also of extrahepatic manifestations such as psychiatric conditions including psychosis. Colombia is a country with multiple social, economic, educational and basic health access problems for the population and high prevalence of HCV infection. To date there are no data showing the association between HCV infection and psychosis in Colombia. Methods & Materials: An ecological study using data from health information system RIPS (Individual Record of Provision of Health Services) in Colombia, for chronic HCV infection (B18.2) and acute polymorphic psychotic disorder with and without symptoms of schizophrenia (F23.1 and F23.0, respectively). We used reference populations to calculate incidence rates of (cases/100,000pop.) for the period 2009-2016. Nonlinear regression models were run between chronic HCV infection (independent variable) rates and psychoses rates (dependent variables) (p < 0.05), using licensed Stata IC 14®. Results: Cumulative rate for chronic HCV infection was estimated in 6.49 cases/100,000 pop, increasing from 2009 (0.88) to 2013 (1.77), whilst for psychosis without schizophrenia 12.79, varying from 0.8 (2016) to 2.51 (2012), and with schizophrenia 10.99, varying from 0.78 (2012) to 2.21 (2014). The variation in incidence of those psychotic disorders showed a significant association in the models (r2 > 0.24, p < 0.01), being for the acute polymorphic psychotic disorder without schizophrenia: r2 = 0.2422, p < 0.0001 and for the acute polymorphic psychotic disorder with schizophrenia: r2 = 0.4451, p < 0.0001. Conclusion: In this study, the prevalence of psychosis (specifically acute psychotic episodes) was significantly associated with the prevalence HCV infection in Colombia during the years 2009 to 2016. This results matched with the findings in other countries. Knowing the association between HCV infection and psychosis opens the gate to increase the knowledge about both pathologies, but also it gives us tools to prevent and to treat the comorbidities and consequences of this infection. This study is the starting line to establishing the association of psychosis and HCV infection in our country.