Ongoing transmission of hepatitis B virus infection among inmates at a state correctional facility.
OBJECTIVE
We sought to determine hepatitis B virus (HBV) infection prevalence, associated exposures, and incidence among male inmates at a state correctional facility.


METHODS
A cross-sectional serological survey was conducted in June 2000, and susceptible inmates were retested in June 2001.


RESULTS
At baseline, 230 inmates (20.5%; 95% confidence interval [CI]=18.2%, 22.9%) exhibited evidence of HBV infection, including 11 acute and 11 chronic infections. Inmates with HBV infection were more likely than susceptible inmates to have injected drugs (38.8% vs 18.0%; adjusted prevalence odds ratio [OR]=3.0; 95% CI=1.9, 4.9), to have had more than 25 female sex partners (27.7% vs 17.5%; adjusted prevalence OR=2.0; 95% CI=1.4, 3.0), and to have been incarcerated for more than 14 years (38.4% vs 17.6%; adjusted prevalence OR=1.7; 95% CI=1.1, 2.6). One year later, 18 (3.6%) showed evidence of new HBV infection. Among 19 individuals with infections, molecular analysis identified 2 clusters involving 10 inmates, each with a unique HBV sequence.


CONCLUSIONS
We documented ongoing HBV transmission at a state correctional facility. Similar transmission may occur at other US correctional facilities and could be prevented by vaccination of inmates.
Khan
Amy J
AJ
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
Simard
Edgar P
EP
Bower
William A
WA
Wurtzel
Heather L
HL
Khristova
Marina
M
Wagner
Karla D
KD
Arnold
Kathryn E
KE
Nainan
Omana V
OV
LaMarre
Madeleine
M
Bell
Beth P
BP
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001483:Base Sequence / Q000235:genetics; D002908:Chronic Disease; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000635:transmission*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010802:Phylogeny; D011159:Population Surveillance; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications; D013997:Time Factors; D014611:Vaccination / Q000706:statistics & numerical data
D004279:DNA, Viral