Prevalence of infection with hepatitis B and C viruses and co-infection with HIV in three jails: a case for viral hepatitis prevention in jails in the United States.
Hepatitis B vaccination and targeted testing for hepatitis C virus (HCV) are recommended for jails with medical services available. This study estimates hepatitis B virus (HBV) and HCV infection prevalence among jail inmates, since most previous studies have been conducted among prison inmates. Prison and jail populations differ: jails hold a wide spectrum of persons for an average of 10-20 days, including persons awaiting arraignment, trial, conviction, or sentencing, while prisons typically hold convicted criminals for at least 1 year. A stratified random sample of sera obtained during routine syphilis testing of inmates entering jails in Chicago (March-April 2000), Detroit (March-August 1999), and San Francisco (June 1999-December 2000) was tested for serologic markers of HBV and HCV infection. All sera had been previously tested for antibody to HIV (anti-HIV). A total of 1,292 serum samples (12% of new inmates) was tested. Antibody to HCV (anti-HCV) prevalence was 13%. Antibody to hepatitis B core antigen (anti-HBc) prevalence was 19%, and hepatitis B surface antigen (HBsAg) prevalence was 0.9%; 12% had serologic evidence of hepatitis B vaccination. Hispanics had high rates of chronic HBV infection (3.6% HBsAg positive) along with Asians (4.7% HBsAg positive). Among HIV-infected persons, 38% were anti-HCV positive and 8.2% were HBsAg positive. Anti-HBc positivity was associated with anti-HCV positivity (aOR=4.58), anti-HIV positivity (aOR=2.94), syphilis infection (aOR=2.10), and previous incarceration (aOR=1.78). Anti-HCV-positivity was associated with anti-HBc positivity (aOR=4.44), anti-HIV-positivity (aOR=2.51), and previous incarceration (aOR=2.90). Jail entrants had high levels of HCV and HBV infection and HIV co-infection; HBV prevalence was comparable to previous prison studies, and HCV prevalence was lower than prison studies. Hispanics had an unexpectedly high rate of chronic hepatitis B infection and had the lowest rate of hepatitis B vaccination. The finding that hepatitis B vaccination coverage among jail entrants is lower than the general population, despite this population's increased risk for infection, highlights the need to support vaccination in jail settings.
Hennessey
Karen A
KA
Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention NCHHSTP, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA. khennessey@cdc.gov
Kim
Andrea A
AA
Griffin
Vivian
V
Collins
Nicoline T
NT
Weinbaum
Cindy M
CM
Sabin
Keith
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006306:Health Surveys; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D008297:Male; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D006510:Hepatitis B Antibodies; D018937:Hepatitis C Antibodies