Hepatitis C screening in bipolar veterans

OBJECTIVES: To determine the rates of hepatitis C virus (HCV) risk factors, testing, and diagnosis in bipolar veterans. METHODS: Subjects included all 112 veterans enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder at the Portland Veteran's Administration Medical Center as of August 6, 2004. Charts were reviewed for demographic data (including era of service), testing and diagnosis of HCV, and having a current or former substance use disorder. RESULTS: All veterans enrolled in the study met criteria for bipolar I or bipolar II disorders. Eighty-two (72%) veterans were tested for HCV and of these, 10 (12%) were antibody positive for HCV. All of the 10 HCV antibody positive veterans had at least 1 risk factor for HCV: 6 had a current or past substance use disorder, and 6 were Viet-Nam era veterans (2 had both risk factors). Among the untested sample (N=30), 67% have at least 1 risk factor for HCV. There was no significant difference between the 72% tested and the 28% not tested in the proportion of those with substance use disorders (χ=0.36, df=1, P=0.850), or those who served during the Viet-Nam era (χ=2.89, df=1, P=0.089). Of the 76% with a history of substance abuse 72% of them were tested for HCV which is the same percentage of veterans without a history of substance abuse who were tested (χ=0.987, df=1, P=0.000). CONCLUSIONS: The prevalence of HCV in our tested bipolar population (12%) is higher than both the national average (1.8%) and the average for all United States veterans using Veterans Administration facilities (5.4%). Although the sample size is relatively small, these data suggest that screening for HCV in veterans diagnosed with bipolar disorder is warranted particularly if they have comorbid substance use disorders.