Prevalence and determinants of hepatitis B antigenemia in 15,007 inmates in Taiwan.
BACKGROUND
The goal of this study was to determine the prevalence and risk factors for horizontal transmission of hepatitis B infection due to intravenous drug abuse (IVDA), tattooing, blood transfusion, and combinations of these risk factors.


METHODS
All people detained in 19 prisons were invited to participate. Subjects underwent a physical examination and completed a questionnaire. Blood samples were collected and screened for hepatitis B surface antigen and Venereal Disease Research Laboratory (VDRL) reactivity.


RESULTS
A total of 16 204 prisoners were invited to participate. The response rate was 92.6% and the mean age was 29.73 years. The overall prevalence of HBsAg positivity was 21.7%. Among 3333 subjects with a history of blood transfusion, the carrier rate was 23.19%. Among the 3071 subjects with a history of IVDA and the 6908 subjects with tattoos, the carrier rate was 26.4% and 29.3%, respectively. IVDA appeared to be the strongest risk factor among the 3, with an adjusted odds ratio (AOR) of 1.54 (95% confidence interval, 1.27-1.86), followed by tattooing (1.40, 1.23-1.55), and blood transfusion (1.27, 1.05-1.61). When blood transfusion was combined with either of the other 2 risk factors, the risk increased multiplicatively, and the combination of the 3 factors increased the AOR to 2.76 (2.20-3.47). The prevalence of a positive VDRL test result was 1.01%.


CONCLUSIONS
The prevalence of HBV antigenemia in prisoners was high and was associated with BT, IVDA, and tattooing. A national vaccination program against HBV should be considered for prisoners and other people with these risk factors.
Lin
Ching-Feng
CF
Department of Internal Medicine, Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan.
Twu
Shiing-Jer
SJ
Chen
Ping-Ho
PH
Cheng
Jror-Serk
JS
Wang
Jung-Der
JD
D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D015819:Substance Abuse, Intravenous / Q000150:complications; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D013653:Tattooing / Q000009:adverse effects; D065227:Transfusion Reaction; D055815:Young Adult
D006514:Hepatitis B Surface Antigens