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HIV prevalence among first‐presentation psychotic patients
Author(s) -
Laher A,
Ariefdien N,
Etlouba Y
Publication year - 2018
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12575
Subject(s) - medicine , psychosis , etiology , psychiatry , human immunodeficiency virus (hiv) , schizophrenia (object oriented programming) , medical record , viral load , pediatrics , immunology
Objectives First‐episode psychosis is a frequent emergency department ( ED ) presentation that may potentially be secondary to an underlying life‐threatening HIV ‐related condition. The aim of this study was to determine the prevalence of HIV infection in patients presenting with a first episode of psychosis. Methods Medical records of 159 consecutive African, Asian, White and mixed ethnicity patients presenting to a tertiary academic hospital ED with a first episode of psychotic features were prospectively reviewed. Results Of the 159 subjects, 63 (39.6%) were HIV positive. An underlying medical condition was the most common aetiology of psychosis in both HIV ‐positive (84.2%) and HIV ‐negative (35.4%) subjects, but was significantly more common in HIV ‐positive individuals ( P < 0.001). Substance‐induced psychotic disorders and other primary psychiatric disorders were significantly more common in subjects without HIV infection ( P < 0.001 and P < 0.001, respectively). While there were more men in the HIV ‐negative group (66.7%), gender distribution was almost equal in the HIV ‐infected group (49.2% male). Overall, as well as in both groups, most subjects were of African race, were unemployed and had not completed high school. Conclusions Co‐occurrence of HIV infection was a frequent finding in first‐episode psychotic individuals residing in a high‐prevalence HIV setting. These individuals are more likely to have an underlying medical condition precipitating the onset of psychosis, not to have been initiated on antiretroviral therapy and to present with a low CD 4 cell count and high HIV viral load.