title: [Chronic hepatitis C virus infection and associated liver disease among the inmates of a Spanish prison].
abstract: 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.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital General Universitario de Alicante, Alicante, España.
authors.forename: José
authors.initials: J
authors.lastname: Murcia
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.forename: Miguel
authors.initials: M
authors.lastname: Bedia
authors.forename: José M
authors.initials: JM
authors.lastname: Palazón
authors.forename: José
authors.initials: J
authors.lastname: Sánchez-Payá
authors.forename: Pablo
authors.initials: P
authors.lastname: Saiz de la Hoya
authors.forename: Artemio
authors.initials: A
authors.lastname: Payá
authors.forename: Vicente
authors.initials: V
authors.lastname: Boix
authors.forename: Esperanza
authors.initials: E
authors.lastname: Merino
authors.forename: Sergio
authors.initials: S
authors.lastname: Reus
mesh_terms: 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
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral