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Hepatitis C-associated late-onset schizophrenia: a nationwide, population-based cohort study.


ABSTRACT:

Background

Whether infection with the hepatitis C virus (HCV) causes schizophrenia - and whether the associated risk reverses after anti-HCV therapy - is unknown; we aimed to investigate these topics.

Methods

We conducted a nationwide, population-based cohort study using the Taiwan National Health Insurance Research Database (TNHIRD). A diagnosis of schizophrenia was based on criteria from the International Classification of Diseases, 9th revision (295.xx).

Results

From 2003 to 2012, from a total population of 19 298 735, we enrolled 3 propensity-score-matched cohorts (1:2:2): HCV-treated (8931 HCV-infected patients who had received interferon-based therapy for ≥ 6 months); HCV-untreated (17 862); and HCV-uninfected (17 862) from the TNHIRD. Of the total sample (44 655), 82.81% (36 980) were 40 years of age or older. Of the 3 cohorts, the HCV-untreated group had the highest 9-year cumulative incidence of schizophrenia (0.870%, 95% confidence interval [CI] 0.556%-1.311%; p < 0.001); the HCV-treated (0.251%, 95% CI 0.091%-0.599%) and HCV-uninfected (0.118%, 95% CI 0.062%-0.213%) cohorts showed similar cumulative incidence of schizophrenia (p = 0.33). Multivariate Cox analyses showed that HCV positivity (hazard ratio [HR] 3.469, 95% CI 2.168-5.551) was independently associated with the development of schizophrenia. The HCV-untreated cohort also had the highest cumulative incidence of overall mortality (20.799%, 95% CI 18.739%-22.936%; p < 0.001); the HCV-treated (12.518%, 95% CI 8.707%-17.052%) and HCV uninfected (6.707%, 95% CI 5.533%-8.026%) cohorts showed similar cumulative incidence of mortality (p = 0.12).

Limitations

We were unable to determine the precise mechanism of the increased risk of schizophrenia in patients with HCV infection.

Conclusion

In a population-based cohort (most aged ≥ 40 years), HCV positivity was a potential risk factor for the development of schizophrenia; the HCV-associated risk of schizophrenia might be reversed by interferon-based antiviral therapy.

SUBMITTER: Cheng JS 

PROVIDER: S-EPMC8565883 | biostudies-literature | 2021 Nov-Dec

REPOSITORIES: biostudies-literature

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Publications

Hepatitis C-associated late-onset schizophrenia: a nationwide, population-based cohort study.

Cheng Jur-Shan JS   Hu Jing-Hong JH   Chang Ming-Yu MY   Lin Ming-Shyan MS   Ku Hsin-Ping HP   Chien Rong-Nan RN   Chang Ming-Ling ML  

Journal of psychiatry & neuroscience : JPN 20211102 6


<h4>Background</h4>Whether infection with the hepatitis C virus (HCV) causes schizophrenia - and whether the associated risk reverses after anti-HCV therapy - is unknown; we aimed to investigate these topics.<h4>Methods</h4>We conducted a nationwide, population-based cohort study using the Taiwan National Health Insurance Research Database (TNHIRD). A diagnosis of schizophrenia was based on criteria from the <i>International Classification of Diseases</i>, 9th revision (295.xx).<h4>Results</h4>F  ...[more]

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