Substance abuse and the transmission of hepatitis C among persons with severe mental illness.

Journal Article (Journal Article)

OBJECTIVES: The authors sought to better understand the relationship of substance abuse to higher rates of transmission of hepatitis C among persons with severe mental illness. METHOD: S: The authors assessed 668 persons with severe mental illness for HIV, hepatitis B, and hepatitis C infection through venipuncture. Demographic characteristics, substance abuse, and risk behaviors for blood-borne infections were assessed through interviews and collection of clinical data. RESULTS: Eighty-two percent of the assessed persons were not infected, and 18 percent had hepatitis C. Among those with hepatitis C infection, 546 (82 percent) tested negative for all viruses. Of the 122 (18 percent) who had hepatitis C, 53 (8 percent) had only hepatitis C, 56 (8 percent) had both hepatitis C and hepatitis B, three (1 percent) had hepatitis C and HIV, and ten (2 percent) had all three infections. More than 20 percent of the sample reported lifetime intravenous drug use, and 14 percent reported lifetime needle sharing. Fifty-seven percent had sniffed of snorted cocaine, and 39 percent had smoked crack. A stepwise regression model was used to identify interaction effects of these behaviors and risk of hepatitis C infection among persons with severe mental illness. Use of needles and of crack cocaine were associated with a large increase in the likelihood of hepatitis C infection. CONCLUSION: S: The high rates of co-occurring substance use disorders among persons with severe mental illness, coupled with the role of substance abuse as the primary vector for hepatitis C transmission, warrants special consideration.

Full Text

Duke Authors

Cited Authors

  • Osher, FC; Goldberg, RW; McNary, SW; Swartz, MS; Essock, SM; Butterfield, MI; Rosenberg, SD; Five-Site Health and Risk Study Research Committee,

Published Date

  • June 2003

Published In

Volume / Issue

  • 54 / 6

Start / End Page

  • 842 - 847

PubMed ID

  • 12773598

International Standard Serial Number (ISSN)

  • 1075-2730

Digital Object Identifier (DOI)

  • 10.1176/


  • eng

Conference Location

  • United States