HIV, hepatitis B, and hepatitis C infections are more prevalent among patients with severe mental illness than in the general population, according to data published in the Lancet.

Clarissa Bauer-Staeb, MSc, from the Division of Psychiatry, University College London, and colleagues conducted a nationwide, population-based, cross-sectional study to determine the prevalence of blood-borne viruses in adults in Sweden older than 18 years of age with a severe mental illness.

In the total adult population of Sweden, 1.43% of individuals had a diagnosis of severe mental illness, defined as a clinical diagnosis of schizophrenia, schizoaffective disorder, bipolar disorder, or other psychotic illnesses. Among the individuals with a severe mental illness, 0.24% had HIV, 0.53% had hepatitis B, and 4.58% had hepatitis C.

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The researchers found that the odds of having HIV were 2.57 times greater among those with severe mental illness than in the general population. In addition, the odds of having hepatitis B were 2.29 times greater among those with severe mental illness, and the odds of having hepatitis C were 6.18 times greater.

The investigators note that substance abuse contributed the most to the increased risk of blood-borne viruses in this population. The odds ratio (OR) of HIV infection in those with severe mental illness compared with the general population was 1.61. Furthermore, the OR for hepatitis B was 1.28, and the OR for hepatitis C was 1.72.

“To effectively address the syndemic of severe mental illness, BBV [blood-borne viruses], and substance misuse, integrated approaches to care that facilitate greater collaboration between mental health, sexual health, and substance misuse services are necessary,” the study authors noted. “Potentially, testing for BBVs should become routinely available during contact with mental health and substance misuse services.”


  1. Bauer-Staeb C, Jorgensen L, Lewis G, Dalman C, Osborn DPJ, Hayes JF. Prevalence and risk factors for HIV, hepatitis B, and hepatitis C in people with severe mental illness: a total population study of Sweden. Lancet. 2017 Jul 4. doi:10.1016/S2215-0366(17)30253-5