title: Prisoners are at risk for hepatitis C transmission.
abstract: OBJECTIVE
  Determine the incidence of hepatitis C virus antibodies among a cohort of prisoners.
  
  
  METHODS
  Follow-up study of a random sample of prisoners who participated in a cross-sectional survey in 1996.
  
  
  METHODS
  29 correctional centres in New South Wales (Australia).
  
  
  METHODS
  181 adult prisoners (163 men and 18 women).
  
  
  RESULTS
  The incidence of hepatitis C virus antibody among the 90 inmates who were seronegative at the first test in 1996 was 7.1 per 100 person-years (16 seroconverters). Among the 90 inmates, 37 had re-entered the prison system following release into the community and 53 had been continuously detained. The seroconversion rate was higher among the re-entrants compared with those who had been continuously incarcerated (10.8 vs. 4.5 per 100 person-years, p=0.07). However, when the data was stratified by injecting status, the serocon-version rate in the two groups was similar. Most of the seroconverters had histories of injecting drug users (14/16). The overall incidence among injectors was 19.3 per 100 person years (95% CI: 9.1-29.2).
  
  
  CONCLUSIONS
  Hepatitis C transmission occurs inside the prison with injecting drug use the likely cause. Among non-injectors, tattooing was the most likely mode of transmission. Harm minimisation measures with proven effectiveness need to be considered for this environment.
authors.affiliation: Centre for Health Research in Criminal Justice, Sydney 2036, Australia. tony.butler@justicehealth.nsw.gov.au
authors.forename: Tony
authors.initials: T
authors.lastname: Butler
authors.forename: Azar
authors.initials: A
authors.lastname: Kariminia
authors.forename: Michael
authors.initials: M
authors.lastname: Levy
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D015994:Incidence; D008297:Male; D011329:Prisoners; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications; D013653:Tattooing / Q000009:adverse effects
chemical_list: D018937:Hepatitis C Antibodies