Abstract
Although high prevalence of hepatitis C virus (HCV) in correctional institutions has been established, data are sparse regarding the comorbidities of hepatitis B virus (HBV), HCV, and human immunodeficiency virus (HIV), all of which may complicate the management of HCV. This study sought to estimate the prevalence and correlates associated with HCV prevalence among entrants into the Maryland Division of Correction and the Baltimore City Detention Center. Participants included all newly incarcerated entrants between January 28 and March 28, 2002. Excess sera with identifiers removed from samples drawn for routine syphilis testing were assayed for antibodies to HIV and HCV and for HBV surface antigen and surface and total core antibodies. Separately, all HIV-positive specimens were tested using the serological testing algorithm for recent HIV seroconversion. Of the 1,081 immates and 2,833 detainees, reactive syphilis serology was noted in 0.6% of the combined population; HIV seroprevalence was 6.6%; HCV prevalence was 29.7%; and 25.2% of detainees and prisoners had antigen or core or surface antibodies to HBV. A multivariate analysis of predictors of HCV positivity indicated that detainees, women, whites, older age groups, those who were HIV seropositive, and individuals with past or present infection with HBV were significantly more likely to be positive for HCV. These data indicate that hepatitis C remains an important public health concern among entrants to jail and prison and is complicated with coinfections that need to be addressed for effective treatment.
Keywords: Hepatitis B virus, Hepatitis C virus, Human immunodeficiency virus, Jail, Prison, Seroprevalence, Syphilis
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References
- 1.Hammett TM, Harmon MP, Rhodes W. The burden of infectious disease among inmates of and releasees from US correctional facilities, 1997. Am J Public Health. 2003;92:1789–1794. doi: 10.2105/ajph.92.11.1789. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Charuvasttra A, Stein J, Schwartzapeel B, et al. Hepatitis B vaccination practices in state and federal prisons. Public Health Rep. 2001;116:203–208. doi: 10.1093/phr/116.3.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Allen S. Developing a systematic approach to hepatitis C for correctional systems: controversies and emerging consensus. HEPP News. 2003;6(4):1–4. [Google Scholar]
- 4.Janssen RS, Satten GA, Stramer SL, et al. New testing strategy to detect early HIV-1 infection for use in incidence estimates and for clinical and prevention purposes. JAMA. 1998;280:42–48. doi: 10.1001/jama.280.1.42. [DOI] [PubMed] [Google Scholar]
- 5.Weinbaum C, Lyerla R, Margolis H. Prevention and control of infections with hepatitis viruses in correctional settings. MM WR Morb Mortal Wkly Rep. 2003;52(RR-1):1–36. [PubMed] [Google Scholar]
- 6.Macalino GE, Rich JD, Sanford-Colby S, Vlahov D. Intake prevalence and intraprison incidence of HIV, hepatitis B (HBV) and hepatitis C (HCV) among sentenced inmates in Rhode Island. International Conference AIDS. July 7–12, 2002; Barcelona, Spain.
- 7.Vlahov D, Brewer F, Castro KG, et al. Prevalence of antibody to HIV-1 among entrants to US correctional facilities. JAMA. 1991;265:1129–1132. doi: 10.1001/jama.265.9.1129. [DOI] [PubMed] [Google Scholar]
- 8.Vlahov D, Munoz A, Brewer F, Taylor E, Canner C, Polk BF. Seasonal and annual variation of antibody to HIV-1 among male inmates entering Maryland prisons: update. AIDS. 1990;4:345–350. doi: 10.1097/00002030-199004000-00010. [DOI] [PubMed] [Google Scholar]
- 9.Garfein RS, Vlahov D, Galai N, Doherty MC, Nelson KE. Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health. 1996;86:655–661. doi: 10.2105/AJPH.86.5.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Thomas DL, Vlahov D, Solomon L, et al. Correlates of hepatitis C virus infections among injection drug users. Medicine. 1995;74:212–220. doi: 10.1097/00005792-199507000-00005. [DOI] [PubMed] [Google Scholar]
- 11.Thomas DL, Astemborski J, Rai RM, et al. The natural history of hepatitis C virus infection host, viral and environmental factors. JAMA. 2000;284:450–456. doi: 10.1001/jama.284.4.450. [DOI] [PubMed] [Google Scholar]
- 12.Strasfeld L, Lo Y, Netski D, Thomas DL, Klein RS. The association of hepatitis C prevalence, activity, and genotype with HIV infection in a cohort of New York City drug users. J Acquir Immune Defic Syndr. 2003;33:356–364. doi: 10.1097/00126334-200307010-00010. [DOI] [PubMed] [Google Scholar]
- 13.Maruschak LM. HIV in Prisons, 2000. Washington, DC: Bureau of Justice Statistics, US Dept of Justice; 2002. [Google Scholar]
- 14.Behrendt C, Kendig N, Dambita C, Horman J, Lawlor J, Vlahov D. Voluntary testing for human immunodeficiency virus (HIV) in a prison population with a high prevalence of HIV. Am J Epidemiol. 1994;139:918–926. doi: 10.1093/oxfordjournals.aje.a117098. [DOI] [PubMed] [Google Scholar]
- 15.Vlahov D, Brewer F, Munoz A, Hall D, Taylor E, Polk BF. Temporal trends of human immunodeficiency virus type 1 (HIV-1) infection among inmates entering a statewide prison system, 1985–1987. J Acquir Immune Defic Syndr. 1989;2:283–290. [PubMed] [Google Scholar]
- 16.Nerenberg RWM, Groot A. HCV in corrections: frontline or backwater? HEPP News. 2002;5(4):1–2. [Google Scholar]
- 17.Bica I, McGovern B, Dhar R, et al. Increasing mortality due to end-stage liver disease in patients with human immunodeficiency virus infection. Clin Infect. Dis. 2001;32:492–497. doi: 10.1086/318501. [DOI] [PubMed] [Google Scholar]
- 18.Allen SA, Spaulding AC, Osei AM, Taylor LE, Cabral AM, Rich JD. Treatment of chronic hepatitis C in a state correctional facility. Ann Intern Med. 2003;138:187–190. doi: 10.7326/0003-4819-138-3-200302040-00010. [DOI] [PubMed] [Google Scholar]