There is no evidence on influence of HBV/HCV co-infection on survival characteristics in population with dual disorders.

To determine the impact of HBV/HCV co-infection on the long-term survival of schizophrenic patients with co-occurring substance use disorders.

Charts of 223 subjects admitted from January 1, 2002 to May 31, 2006 were assessed. The Kaplan–Meier survival analysis was used to estimate the cumulative survival rates. The association between HBV/HCV and mortality was estimated using the Cox proportional-hazard regression models, with adjustments for potential confounders. The main outcome was all-cause mortality. Median observation time was 10.3years.

Total all-cause 11year, unadjusted mortality was 18.0% in population with no viral hepatitis (VH) infection (n=185; 83.0%), 66.7% in population with HBV monoinfection (n=3; 1.3%), 50.0% in population with HCV monoinfection (n=28; 12.6%), and 64.3% in population with HBV/HCV co-infection (n=7; 3.1%), P<0.00001. In Cox regression, the adjusted hazard ratio was 4.22 (95% CI: 1.00–18.63; P<0.05) for the HBV, 4.24 (95% CI: 2.13–8.47; P<0.00001) for the HCV, 6.18 (95% CI: 2.01–19.01; P<0.0015) for the HBV/HCV, all vs. no VH-infection.

The high mortality of schizophrenic dual disorders patients with HBV/HCV necessitates new approaches to secondary and tertiary prevention to reduce the burden of chronic liver disease and to improve survival. The strong adverse effect of HBV/HCV on survival should encourage clinical trials including schizophrenic dual disorders patients on whether patients benefit from treatment choices. It is essential that adequate resources and strategies are targeted to the schizophrenic dual disorders patients with HBV/HCV.