Letter to the Editor in response to the recently published article “Roncero C, Buch B, Martin-Sanchez AM, et al. Prevalence of hepatitis C virus infection in patients with chronic mental disorders: the relevance of dual diagnosis. Gastroenterol Hepatol. 2022”

To the Editor:

We have carefully read an observational study on the prevalence of hepatitis C virus (HCV) infection in the hospitalized population with severe chronic psychiatric disorders and dual diagnosis (DD) recently published in Gastroenterología y Hepatología by Dr. Roncero et al.¹ The main finding of the study was the higher overall prevalence of HCV infection in psychiatric inpatients (3.8%), DD patients (14.3%) and patients with legal incapacity (14.3%) compared to the Spanish general population prevalence of HCV infection.

The authors limit their findings to the chronic severe mental disorder population hospitalized. Certainly, this higher prevalence of HCV infection in patients with serious mental disorders (SMDs) and substance use disorders compared to the general population has been widely reported.² These patients are characterized by chronic conditions and well-defined risk factors associated with a higher prevalence of infection, as recognized by the authors. Our group detected a similar behaviour in a cohort of outpatients with non-affective psychotic disorder as a particular condition within SMDs, which further emphasizes the need for special attention to this infectious disease in this population.³

In fact, the authors highlight the need to include patients with mental disorders, especially those with DD, in HCV screening and treatment programmes with simplified access to treatment and coordination between the Psychiatry and Digestive Units. Certainly, the latest update of the HCV Infection Screening Guide of the Ministry of Health of the Government of Spain already includes the recommendation of screening people with severe mental disorders, a concept that includes all the potential causes of severe mental illness, with or without prior drug use (a situation that cannot always be adequately reflected in the clinical history).⁴ Finally, the ten required actions for the elimination of hepatitis C, endorsed by the Spanish Association for the Study of the Liver (AEEH), the Spanish Society of Digestive Pathology (SEPD) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), already includes in point 8 the screening of patients with serious mental health disorders within certain selected groups of patients for risk factors.⁵