Prevalence of Infection with Hepatitis B and C Viruses and Co-infection with HIV in Three Jails: A Case for Viral Hepatitis Prevention in Jails in the United States
Prevalence of Infection with Hepatitis B and C Viruses and Co-infection with HIV in Three Jails: A Case for Viral Hepatitis Prevention in Jails in the United States
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DOI：
10.1007/s11524-008-9305-8
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发表时间：
2009-01-01
影响因子：
6.6
通讯作者：
Sabin, Keith
中科院分区：
文献类型：
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作者：
Hennessey, Karen A.;Kim, Andrea A.;Sabin, Keith
建议在有医疗服务的监狱进行B型肝炎疫苗接种和丙型肝炎病毒（HCV）有针对性的检测。本研究估计了监狱囚犯中的B型肝炎病毒（HBV）和HCV感染率，因为以前的研究大多数是在监狱囚犯中进行的。监狱和监狱人口不同：监狱关押各种各样的人，平均10-20天，包括等待传讯、审判、定罪或判刑的人，而监狱通常关押已定罪的罪犯至少1年。在芝加哥（2000年3 - 4月）、底特律（1999年3 - 8月）和旧金山弗朗西斯科（1999年6 - 2000年12月）对进入监狱的囚犯进行常规梅毒检测期间获得的血清分层随机样本进行HBV和HCV感染的血清学标志物检测。所有血清先前均已检测HIV抗体（抗HIV）。共检测了1 292份血清样本（占新囚犯的12%）。抗-HCV阳性率为13%。B型肝炎核心抗原抗体（抗-HBc）的患病率为19%，B型肝炎表面抗原（HBsAg）的患病率为0.9%; 12%有B型肝炎疫苗接种的血清学证据。西班牙裔人慢性HBV感染率高（3.6% HBsAg阳性），沿着亚洲人（4.7% HBsAg阳性）。在HIV感染者中，38%抗-HCV阳性，8.2% HBsAg阳性。抗-HBc阳性与抗-HCV阳性（aOR = 4.58）、抗-HIV阳性（aOR = 2.94）、梅毒感染（aOR = 2.10）和既往监禁（aOR = 1.78）相关。抗-HCV阳性与抗-HBc阳性（aOR = 4.44）、抗-HIV阳性（aOR = 2.51）和既往监禁（aOR = 2.90）相关。监狱犯人有高水平的HCV和HBV感染和艾滋病毒合并感染; HBV的流行率与以前的监狱研究相当，HCV的流行率低于监狱研究。西班牙裔人的慢性B型肝炎感染率出乎意料地高，而B型肝炎疫苗接种率最低。尽管监狱进入者的感染风险增加，但监狱进入者的B型肝炎疫苗接种覆盖率低于一般人群，这一发现突出了支持监狱环境中疫苗接种的必要性。
Hepatitis B vaccination and targeted testing for hepatitis C virus (HCV) are recommended for jails with medical services available. This study estimates hepatitis B virus (HBV) and HCV infection prevalence among jail inmates, since most previous studies have been conducted among prison inmates. Prison and jail populations differ: jails hold a wide spectrum of persons for an average of 10-20 days, including persons awaiting arraignment, trial, conviction, or sentencing, while prisons typically hold convicted criminals for at least 1 year. A stratified random sample of sera obtained during routine syphilis testing of inmates entering jails in Chicago (March-April 2000), Detroit (March-August 1999), and San Francisco (June 1999-December 2000) was tested for serologic markers of HBV and HCV infection. All sera had been previously tested for antibody to HIV (anti-HIV). A total of 1,292 serum samples (12% of new inmates) was tested. Antibody to HCV (anti-HCV) prevalence was 13%. Antibody to hepatitis B core antigen (anti-HBc) prevalence was 19%, and hepatitis B surface antigen (HBsAg) prevalence was 0.9%; 12% had serologic evidence of hepatitis B vaccination. Hispanics had high rates of chronic HBV infection (3.6% HBsAg positive) along with Asians (4.7% HBsAg positive). Among HIV-infected persons, 38% were anti-HCV positive and 8.2% were HBsAg positive. Anti-HBc positivity was associated with anti-HCV positivity (aOR = 4.58), anti-HIV positivity (aOR = 2.94), syphilis infection (aOR = 2.10), and previous incarceration (aOR = 1.78). Anti-HCV-positivity was associated with anti-HBc positivity (aOR = 4.44), anti-HIV-positivity (aOR = 2.51), and previous incarceration (aOR = 2.90). Jail entrants had high levels of HCV and HBV infection and HIV co-infection; HBV prevalence was comparable to previous prison studies, and HCV prevalence was lower than prison studies. Hispanics had an unexpectedly high rate of chronic hepatitis B infection and had the lowest rate of hepatitis B vaccination. The finding that hepatitis B vaccination coverage among jail entrants is lower than the general population, despite this population's increased risk for infection, highlights the need to support vaccination in jail settings.