[Chronic hepatitis C virus infection and associated liver disease among the inmates of a Spanish prison].
OBJECTIVE
The objective of this study was to determine the prevalence and genotype distribution of chronic hepatitis C virus (HCV) infection in a penitentiary population. The secondary objective was to describe histological findings in liver of the biopsied population, and identify risk factors associated with liver fibrosis and inflammatory activity.


METHODS
Among 800 inmates, 730 accepted HCV antibody screening and PCR confirmation. Sociodemographic, behavioral, and incarceration-related variables were analyzed. Liver biopsy was offered to individuals with chronic HCV infection. Advanced liver disease was defined as fibrosis 3 and/or an inflammatory activity index score 8).


RESULTS
HCV antibodies were found in 279 inmates. PCR confirmed HCV infection in 250 inmates, yielding a prevalence of 34.2% (95% confidence interval [CI]: 30.8-37.8). Intravenous drug use was independently associated with HCV infection, odds ratio (OR) 51.7 (95% CI: 31-86). Genotypes were 1a 32.9%, 3 29.7%, 1b 18.4% and 4 17.1%. Fifty-one liver biopsies were performed; advanced liver disease was found in 7 patients (13.7%) based on fibrosis and in 31 patients (60.7%) based on the inflammatory activity index. High AST and ALT levels were associated with advanced liver disease established on both fibrosis and inflammatory activity (P<.05). Lengthy intravenous drug use was associated with inflammatory activity (P=.02; OR 1.2; 95% CI: 1.03-1.7).


CONCLUSIONS
Persistent HCV infection is highly prevalent among prison inmates and is associated with intravenous drug abuse. HCV genotype diversity is higher in prison inmates than in the general population. Higher transaminase levels are associated with advanced liver disease.
Murcia
José
J
Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España.
Portilla
Joaquín
J
Bedia
Miguel
M
Palazón
José M
JM
Sánchez-Payá
José
J
Saiz de la Hoya
Pablo
P
Payá
Artemio
A
Boix
Vicente
V
Merino
Esperanza
E
Reus
Sergio
S
D000328:Adult; D018912:Arabs / Q000706:statistics & numerical data; D001706:Biopsy; D015897:Comorbidity; D005060:Europe / Q000208:ethnology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D016133:Polymerase Chain Reaction; D011329:Prisoners / Q000706:statistics & numerical data*; D012367:RNA, Viral / Q000097:blood; D006178:Romani People / Q000706:statistics & numerical data; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D055815:Young Adult
D018937:Hepatitis C Antibodies; D012367:RNA, Viral