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Australian inmates had increased risk for HCV
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Inmates in New South Wales, Australia, were prone to developing hepatitis C virus infection through various means of transmission while incarcerated, according to new study data.
Fabio Luciani, PhD, Inflammation and Infection Research Center, School of Medical Sciences, the University of New South Wales, and colleagues enrolled 210 inmates (mean age, 27 years; 73.8% men) from 19 correctional institutions in the Hepatitis C Incidence and Transmission Study in prisons. Only inmates who were negative for hepatitis C virus (HCV)-RNA and antibody-negative at enrollment were included.
All participants reported long-standing injection drug use (IDU), high prevalence of sharing injection equipment (65%) and tattoos (70%). Follow-ups were performed at 6- to 12-month intervals for up to 4 years.
Fabio Luciani
Researchers said there were 38 incidents of HCV during 269.94 person-years of follow-up with an IR of 14.08 per 100 person-years (95% CI, 9.96-19.32). Almost half of the cohort (n=103) reported IDU during follow-up, and 31% of these participants reported sharing injection equipment. Of them, 21% indicated injecting drugs at least daily, and 24.3% reported injecting heroin.
Others reported fights with blood-to-blood contact (21%), tattooing (20%), being involved in a stabbing (7.1%) or body piercing (9.5%). Female inmates and those with indigenous backgrounds had greater HCV incident rates within the cohort. Univariate analysis revealed indigenous background was associated with an increased risk for HCV infection (P=.003), as was injecting drugs on a daily basis (P<.001) and sharing equipment (P=.01) during follow-up.
“The findings highlight the many challenges remaining in establishing effective prevention strategies for HCV infection in the prison context, given the crowded conditions, uncontrolled exposure to violence and illicit drugs, separation from family networks and emotional deprivation,” the researchers concluded. “Ongoing surveillance of risk behaviors and infection rates, and further research to inform the effectiveness of HCV prevention measures in prisons, are warranted.”
Disclosure: The researchers report no relevant financial disclosures.
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