Schizophrenia and Comorbid Human Immunodeficiency Virus or Hepatitis C Virus
Francine Cournos, MD; Karen McKinnon, MA; and Greer Sullivan, MD, MSPH
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Patients with schizophrenia are at significantly increased risk for infection with human immunodeficiency
virus (HIV), hepatitis C virus, or both. Several factors underlie this increased risk, including
substance abuse and high-risk sexual behavior. Although being sexually active tends to be less common
among patients with schizophrenia than among nonpsychotic individuals, patients with schizophrenia
who are sexually active are more likely than nonpsychotic individuals to engage in high-risk
behavior. Many patients with schizophrenia have inadequate knowledge about the risks of HIV, but
delivering factual information is not likely, by itself, to bring about behavioral changes that reduce the
risk of exposure and transmission. Comorbidity of schizophrenia and life-threatening viral illnesses
incurs a worse prognosis for both conditions. Nevertheless, effective pharmacotherapy exists, and
antipsychotics and highly active antiretroviral treatments for HIV can be used together successfully.
The clinical challenge is to encourage adherence to treatment and to coordinate the clinical services
needed to address the diverse psychiatric and medical problems that coexist in this population.
J Clin Psychiatry 2005;66(suppl 6):27-33
© Copyright 2005 Physicians Postgraduate Press, Inc.
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