title: Addressing the challenges of chronic viral infections and addiction in prisons: the PRODEPIST study.
abstract: OBJECTIVE
  In 2010 only 30.9%, of the Puy-de-Dome prison detainees were screened for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV). Our goal was then to promote these assesments, as well as to identify addictive behaviour using FAGERSTROM, Cannabis Abuse Screening Test and CAGE tests, diagnose fibrosis by means of Fibrometer or Fibroscan in hepatic virus carriers and heavy drinkers, and perform HBV vaccinations.
  
  
  METHODS
  This prospective study of adult detainees in the prisons of Puy-de-Dome, France, took place from June 2012 to December 2013.
  
  
  RESULTS
  Of the 702 incarcerated individuals, 396(56.4%) were screened and 357(50.9%) enrolled. HIV prevalence was 0.3%, HCV 4.7% and HBV 0.6%. While 234/294(79.6%) smokers and 115/145(79.3%) cannabis users were screened for dependence, excessive alcohol consumption was tested for in 91/179(50.8%) cases. Fibrosis was screened for in 75/80(93.7%) individuals selected with 16.0% presenting with moderate to severe fibrosis, 4/9(44.4%) HCV carriers and 8/65(12.3%) excessive alcohol consumers. HBV vaccination was given to 81/149(54.4%) individuals with no serological markers. A total of nine HIV tests were conducted at the 57 discharge consultations, involving 215 detainees being released, all of which were negative.
  
  
  CONCLUSIONS
  The promotion of these evaluations proved beneficial, although viral screening could be achieved for only approaching half of the detainees, as could alcohol consumption assessment and HBV vaccination for those concerned. Fibrosis screening revealed lesions in HCV carriers yet also in heavy drinkers, who are typically less likely to be assessed. Consultations and HIV screening on release were found to be rarely possible.
authors.affiliation: 1 Infectious Diseases Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France cjacomet@chu-clermontferrand.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Jacomet
authors.affiliation: 2 Clermont Ferrand and Riom Prisons Medical Units, Emergency Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
authors.forename: Angeline
authors.initials: A
authors.lastname: Guyot-Lénat
authors.affiliation: 3 Hepatology Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Bonny
authors.affiliation: 4 Virology Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Henquell
authors.affiliation: 5 Emile Roux Centre, CDAG (Free anonymous screening centre), Clermont Ferrand F-63000, France.
authors.forename: Morgane
authors.initials: M
authors.lastname: Rude
authors.affiliation: 1 Infectious Diseases Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
authors.forename: Sylviane
authors.initials: S
authors.lastname: Dydymski
authors.affiliation: 6 Psychiatric Department, Sainte Marie Hospital, Clermont Ferrand F-63000, France.
authors.forename: Jean-Alexandre
authors.initials: JA
authors.lastname: Lesturgeon
authors.affiliation: 7 Clermont-Ferrand University Hospital, Biostatistic Unit (DRCI Clinical research and innovation service), Clermont Ferrand F-63000, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Lambert
authors.affiliation: 7 Clermont-Ferrand University Hospital, Biostatistic Unit (DRCI Clinical research and innovation service), Clermont Ferrand F-63000, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: 2 Clermont Ferrand and Riom Prisons Medical Units, Emergency Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
authors.forename: Jeannot
authors.initials: J
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000196:embryology; D016739:Behavior, Addictive; D002908:Chronic Disease; D005260:Female; D005602:France; D015658:HIV Infections / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods*; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D014777:Virus Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy