Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining
Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining
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DOI：
10.1177/003335491412900213
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发表时间：
2014-03-01
影响因子：
3.3
通讯作者：
Spaulding, Anne C.
中科院分区：
文献类型：
--
作者：
Varan, Aiden K.;Mercer, Daniel W.;Spaulding, Anne C.
目标。尽管美国的丙型肝炎流行对矫正人群的影响不成比例，但这些人群的血清学患病率和疾病负担的最后一次全国估计是在十多年前。我们调查了在州监狱系统中进行的常规丙型肝炎监测，并更新了以前的估计。我们调查了美国所有州的惩教部门，以确定自2001年以来哪些州的监狱系统进行了常规丙型肝炎筛查。利用这些监狱系统的血清流行率数据，我们估计了2006年全国囚犯中丙型肝炎的血清流行率，以及矫正人群所承担的流行病份额。在2001年至2012年进行常规检测的至少12个州中，丙型肝炎的血清患病率从9.6%到41.1%不等。除一个州外，所有州的多项测量结果均显示血清阳性率下降。我们估计2006年全国各州囚犯的血清患病率为17.4%。根据估计的美国监狱总人数，我们预计当年有1,857,629名丙型肝炎抗体患者被监禁。我们估计，2006年美国丙型肝炎总病例中，监狱人口占28.5%-32.8%，低于2003年的39%。我们的研究结果提供了一个重要的丙型肝炎血清患病率的最新估计，并表明矫正人群承担了下降，但仍然相当大的流行病份额。惩教设施仍然是发现丙型肝炎病例和实施治疗的重要场所。这些结果也可能有助于未来的研究，以预测在监狱系统中提供新的治疗方案的社会成本和效益。
Objectives. Although the hepatitis C epidemic in the United States disproportionately affects correctional populations, the last national estimates of seroprevalence and disease burden among these populations are more than a decade old. We investigated routine hepatitis C surveillance conducted in state prison systems and updated previous estimates.Methods. We surveyed all U.S. state correctional departments to determine which state prison systems had performed routine hepatitis C screening since 2001. Using seroprevalence data for these prison systems, we estimated the national hepatitis C seroprevalence among prisoners in 2006 and the share of the epidemic borne by correctional populations.Results. Of at least 12 states performing routine testing from 2001 to 2012, seroprevalences of hepatitis C ranged from 9.6% to 41.1%. All but one state with multiple measurements demonstrated declining seroprevalence. We estimated the national state prisoner seroprevalence at 17.4% in 2006. Based on the estimated total U.S. correctional population size, we projected that 1,857,629 people with hepatitis C antibody were incarcerated that year. We estimated that correctional populations represented 28.5%-32.8% of the total U.S. hepatitis C cases in 2006, down from 39% in 2003.Conclusions. Our results provide an important updated estimate of hepatitis C seroprevalence and suggest that correctional populations bear a declining but still sizable share of the epidemic. Correctional facilities remain important sites for hepatitis C case finding and therapy implementation. These results may also assist future studies in projecting the societal costs and benefits of providing new treatment options in prison systems.