Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs

BMC Public Health

Stuart A Kinner²  Nicholas G Lennox¹  David B Preen³  Jesse T Young³  Kathryn J Snow⁴ 

[1] Queensland Centre for Intellectual and Developmental Disability, University of Queensland, Brisbane, Australia;Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia;National Drug Research Institute, Curtin University, Perth, Australia;Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

关键词: Incarceration;    Injecting drug use;    Prison;    HCV;    Hepatitis C virus;   

Others  :  1128649
DOI  :  10.1186/1471-2458-14-830

 received in 2014-04-28, accepted in 2014-08-05,  发布年份 2014

【 摘 要 】

Background

Hepatitis C virus (HCV) infection is common among prisoners, particularly those with a history of injecting drug use (IDU). Incarcerated people who inject drugs frequently report high-risk injecting practices both in prison and in the community. In spite of rising morbidity and mortality, utilisation of HCV-related services in Australia has been persistently low. This study aimed to describe the incidence, prevalence and correlates of HCV seropositivity in a large cohort of prisoners who have injected drugs, and to identify correlates of receiving confirmation of active infection.

Methods

Data-linkage to a State-wide statutory notifiable diseases surveillance system was used to investigate the incidence of notified HCV seropositivity, seroconversion and confirmed HCV infection in a cohort of 735 prisoners with a history of IDU, over 14 years of follow up. Hepatitis C test results from prison medical records were used to identify correlates of testing positive in prison.

Results

The crude incidence of HCV notification was 5.1 cases per 100 person-years. By the end of follow up, 55.1% of the cohort had been the subject of a HCV-related notification, and 47.4% of those tested in prison were HCV seropositive. In multivariable analyses, injecting in prison was strongly associated with HCV seropositivity, as was opioid use compared to injection of other drugs. The rate of reported diagnostic confirmation among those with notified infections was very low, at 6.6 confirmations per 100 seropositive participants per year.

Conclusions

Injecting drugs in prison was strongly associated with HCV seropositivity, highlighting the need for increased provision of services to mitigate the risk of transmission within prisons. Once identified as seropositive through screening, people with a history of IDU and incarceration may not be promptly receiving diagnostic services, which are necessary if they are to access treatment. Improving access to HCV-related services will be of particular importance in the coming years, as HCV-related morbidity and mortality is increasing, and next generation therapies are becoming more widely available.

【 授权许可】

   
2014 Snow et al.; licensee BioMed Central Ltd.

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