Patients with HIV Six Times as Likely to Have Schizophrenia

MARCH 09, 2018
Kevin Kunzmann
Kalysha Closson, MScKalysha Closson, MSc
There is a six-fold prevalence of schizophrenia in people with HIV than that of the population without the virus, according to the results of a Vancouver, BC, Canada-based study.

The study, presented at the 25th Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, MA, this week, found a distinct association between the mental disorder and HIV — a relationship sparsely analyzed before.

Researchers from the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, performed a population-based retrospective cohort study that estimated schizophrenia prevalence and mortality outcomes in the people living with HIV, and a randomly selected 10% sample of individual in British Columbia, from 1998 to 2013.

Led by research coordinator Kalysha Closson, MSc, the team assessed schizophrenia prevalence with physician and hospital-based administrative data, as well as International Classification of Disease 9/10 codes.

The survival time by HIV-status was accessed by a Kaplan-Meier plot, and age and sex-adjusted mortality rates were calculated with the 2016 Canada population used as reference. Researchers examined the association between HIV and all-cause mortality among patients with schizophrenia using logistic regression.

Results showed that, of the 515,913 British Columbia residents from 1998 to 2013 observed in the study, 13,412 (2.6%) were people living with HIV. Schizophrenia was diagnosed in 6.3% of that population — a significant jump from the diagnosis rate in the non-HIV population (1.1%; P < 0.001).

Among those with both HIV and schizophrenia, the population was mostly male (75%), living in an urban setting (91%), had a history of injection drug use (75%), and was at least once on anti-psychotic medication (49%; P <0.001). The population of patients with schizophrenia, but not HIV, reported lesser rates for injection drug use (20%) and antipsychotic medication (39%).

Through the Kaplan-Meier plot, researchers indicated that time from schizophrenia diagnoses to death was significantly short for those with HIV than those without (P < 0.001). Controlling for sex, baseline age, and injection drug age, HIV status was significantly associated with mortality in patients with schizophrenia (aOR= 2.31; 95% CI; 1.84-2.89).

Closson said the results indicate 2 reactions: that patients with schizophrenia but not HIV need to be better monitored for the virus, and that patients with both conditions need access to better care and psychiatric access.

“We found that with this group — because they had the highest mortality — having access to psychiatric care or psychiatric meds, as well as accessing a psychiatrist, was associated with reduced odds of mortality,” Closson said.

Closson noted that patients are generally treated for conditions in regard to the condition’s specialty — very few “one-stop shops” exist for patients suffering from both a virus and a mental condition.

She called for more holistic services to be put in place, in order to ensure such patients have continued care and lessened mortality risk.

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