Study on the Prevalence of Hepatitis C In a psychiatRic Population
Study on the Prevalence of Hepatitis C In a psychiatRic Population
Viral hepatitis, especially hepatitis C, is a major public health issue. Nowadays, very few
 studies in France have evaluated the prevalence of hepatitis C in a psychiatric environment.

 In 2019, at the time of new treatments for HCV, it therefore seems essential to update the
 available data by estimating the prevalence of chronic active hepatitis C in psychiatric
 population. In addition to an update of epidemiological data, it is of high importance to
 assess the effectiveness of the care pathway for patients in whom chronic active hepatitis C
 is diagnosed, including the cascade of care, currently too inefficient despite treatments
 that are themselves ultra-efficient. Indeed, it is essential that once hepatitis is detected,
 it is formally diagnosed, then that the patient actually starts care and is adherent to
 treatment (take his treatment according to the prescription and until the end: this implies
 that the patient accepts his or her illness and understands the value of the prescribed
 treatments), to hope to cure the infection.

 In this context, the SaPHIR study will allow to test a systematic screening of patients in an
 adult psychiatric environment, through rapid diagnostic tests (RDT). The objective is to
 promote the adherence of patients, and to assess possible obstacles in order to optimize the
 screening (RDTs), diagnosis (confirmation of only positive RDTs by venous sampling) and care
 management circuits in routine practice. In addition, the study envisages a combined
 HCV-HBV-HIV screening, taking into account the cross-infection risk (same mode of
 contamination, same risk population, frequent co-infections, more severe liver pathology in
 case of co-infection, etc.), thus making it possible to take care of the patient as a whole.
 The results of the SaPHIR study can ultimately be sent to the French health authorities to
 improve screening and care circuits, and their coverage by social security.
Participation in the SaPHIR study will be offered to patients admitted to one of the
 inpatient or outpatient adult psychiatric units of the hospitals participating in the study
 (around Nantes), provided that the realization of the RDTs will be possible.

 1. Cross-sectional assessment of prevalence : evaluation of the prevalence of HCV, HBV and
 HIV viral infections All patients admitted to one of the inpatient or outpatient adult
 psychiatric units of the hospitals participating in the study, whatever the psychiatric
 diagnosis and without age limit, may be included in the study, provided that the
 realization of the RDTs will be possible. Only patients who will accept the realization
 of the HCV RDT will be included, in order to be able to respond to the primary objective
 of the study. The agreement to realize the two other RDTs is optional. However, for
 patients who already had a HCV serology performed less than 3 months before inclusion,
 the HCV RDT will not be performed and the data collected for the study will be based on
 the previous serology.

 2. Cohort follow-up of HCV positive patients : evaluation of care pathway and barriers to
 care for hepatitis C Patients who are included in the cross-sectional assessment of
 prevalence of the SaPHIR study and having a positive HCV RDT (or positive HCV serology
 performed less than 3 months ago) will participate in the follow-up of the study.
Inclusion Criteria:

 1. Cross-sectional assessment of prevalence

 Patients with all the following characteristics can be included:

 -  Patient admitted to one of the inpatient or outpatient adult psychiatric units of
 the hospitals participating in the study

 -  Patient accepting the realization of the HCV RDT (or patient with positive HCV
 serology performed less than 3 month ago)

 2. Cohort follow-up of HCV positive patients:

 Patients who are included in the cross-sectional assessment of prevalence of the SaPHIR
 study and having a positive HCV RDT (or positive HCV serology performed less than 3 months
 ago) will participate in the follow-up of the study.

 Exclusion Criteria:

 1. Cross-sectional assessment of prevalence:

 Patients with at least one of the following characteristics cannot be included:

 -  Minors under 15 years of age (all units involved in the recruitment are adult
 psychiatry units, for which the minimum age limit is 15 years and 3 months);

 -  Pregnant or lactating woman;

 -  Participating simultaneously in another interventional research on a drug (so as
 not to interfere with the biological assays);

 -  Not mastering the reading and writing of the French language well enough.

 -  Patient placed under judicial protection

 2. Cohort follow-up of HCV positive patients Patients who are included in the
 cross-sectional assessment of prevalence of the SaPHIR study, with negative RDT HCV
 (or negative HCV serology performed less than 3 months ago) cannot participate in the
 follow-up of the study.