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. 2019 Nov 9;19(1):955.
doi: 10.1186/s12879-019-4581-3.

Prevalence of Viremic Hepatitis C, Hepatitis B, and HIV Infection, and Vaccination Status Among Prisoners in Stockholm County

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Free PMC article

Prevalence of Viremic Hepatitis C, Hepatitis B, and HIV Infection, and Vaccination Status Among Prisoners in Stockholm County

Caroline Gahrton et al. BMC Infect Dis. .
Free PMC article

Abstract

Background: Identification and knowledge of settings with high prevalence of hepatitis C virus (HCV) infection is important when aiming for elimination of HCV. The primary aim of this study was to estimate the prevalence of viremic HCV infection among Swedish prisoners. Secondary aims were to estimate the prevalence of hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV), and the proportion who have received hepatitis B virus (HBV) vaccination.

Methods: A cross-sectional study of all incarcerated persons (n = 667) at all prisons (n = 9) in Stockholm County was conducted. All prisoners are routinely offered opt-in screening for HCV antibodies (anti-HCV), HCV RNA, HBsAg, anti-HBs, anti-HBc and HIV Ag/Ab at prison in Sweden. Data on the results of these tests and the number of received HBV vaccine doses were collected from the prison medical records. The parameters of HCV RNA, anti-HCV, and occurrence of testing for HCV were analysed in multiple logistic regression models in relation to age, sex and prison security class.

Results: The median age was 35 (IQR 26-44) years, and 93.4% were men. Seventy-one percent (n = 471) had been tested for anti-HCV, 70% (n = 465) for HBsAg and 71% (n = 471) for HIV. The prevalence of anti-HCV, HCV RNA, HBsAg and HIV Ag/Ab was 17.0, 11.5, 1.9, and 0.2%, respectively among tested persons. The proportion of prisoners who had received full HBV vaccination was 40.6% (n = 271) among all study subjects.

Conclusions: The prevalence of viremic HCV infection among Swedish prisoners in Stockholm County was 11.5%, which is high in comparison to the general population. Therefore, when aiming for the WHO goal of HCV elimination, prisons could suit as a platform for identification and treatment of HCV infection. There is a need to increase testing for blood-borne viruses and to improve vaccination coverage against HBV in Swedish prisons.

Keywords: HCV RNA; HIV; Hepatitis B; Hepatitis C; Prevalence; Prison; Screening; Vaccination; Viremic HCV infection.

Conflict of interest statement

K. L. has received honoraria for lectures/consultancy fee from AbbVie, Gilead, BMS and MSD and research grant from Abbvie and MSD. F. Ö. has received honoraria for lectures from AbbVie. O. D. has received honoraria for lectures/consultancy fee from AbbVie, Gilead, MSD/Merck and research grants from AbbVie, Gilead, and MES/Merck. A.D. has received honoraria for lectures/consultancy fee from AbbVie, BMS, Gilead and MSD. S. A. has received honoraria for lectures/consultancy fee from AbbVie, BMS, Gilead, MSD/Merck and research grants from AbbVie and Gilead.

Figures

Fig. 1
Fig. 1
Cascade of testing for viremic hepatitis C virus (HCV) of incarcerated persons at all nine prisons in Stockholm County. Abbreviations: HCV, hepatitis C virus; anti-HCV, hepatitis C virus antibodies; HCV RNA, hepatitis C virus ribonucleic acid

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