HIV-Positive Patients Six Times More Likely to Have Schizophrenia

A recent study has found that patients with HIV are six times more likely to have schizophrenia compared with those who do not have the virus.

A recent study has found that patients with HIV are six times more likely to have schizophrenia compared with those who do not have the virus.

The study, led by research coordinator Kalysha Closson, MSc, was presented at the 25th Conference on Retroviruses and Opportunistic Infections (CROI) 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, conducted a population-based retrospective cohort study that estimated schizophrenia prevalence and mortality outcomes in individuals living with HIV, as well as a 10% random sample of individuals in British Columbia, from 1998 to 2013.

For the study, the research team assessed schizophrenia prevalence using 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.

The researchers found that of the 515,913 British Columbia residents from 1998 to 2013 observed in the study, 13,412 (2.6%) were individuals living with HIV. Furthermore, schizophrenia was diagnosed in 6.3% of that population — significantly higher than the diagnosis rate in the non-HIV population (1.1%; P < 0.001).

Among those who had both HIV and schizophrenia, the population was mostly male (75%), residing within an urban setting (91%), with 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, who were not HIV-positive, reported lesser rates of injection drug use (20%) and use of antipsychotic medication (39%).

Through the Kaplan-Meier plot, researchers indicated that time from schizophrenia diagnoses to death was significantly short for those with HIV compared to those without the virus (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).

The results indicate 2 reactions, according to Closson: that patients with schizophrenia who do not have HIV need to be better monitored for the virus, and that patients with both conditions need 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.

Patients are usually treated for conditions in regard to the condition’s specialty, according to Closson. Very few “one-stop shops” exist for patients who are suffering from both virus and mental condition.

More holistic services need to be put in place, Closson said, to ensure these patients have continued care and lessened mortality risk.