Acute Hepatitis C Virus Infection in the Prison Population

在数百万被监禁的人中，大约有20%-40%的人感染了丙型肝炎病毒 在美国。虽然许多研究已经表征了慢性丙型肝炎的血清发病率 关于急性丙型肝炎病毒感染的问题，没有一个国家具体处理过。自.以来 监禁与新的静脉注射毒品有关，这样的人将在 急性丙型肝炎病毒感染的高风险。对高危人群的筛查将有助于深入了解 个人的发病率和临床病程，并允许表征他们的免疫 回应。此外，早期治疗丙型肝炎的效果要好得多。 感染，因此确认急性丙型肝炎病毒感染者具有极大的临床益处 大大提高了根除病毒的可能性。诸如咨询、安全针头技术和甲型肝炎和乙肝病毒免疫接种等干预措施也是 这是必要的。在没有任何系统方法的情况下，初步努力在30个月的时间里从两个被监禁的人中确认了19例急性丙型肝炎病例。该项目旨在改善马萨诸塞州惩教所内此类受试者的识别 系统，描述他们的临床过程，同时提供咨询、教育和 对已确认身份的个人的治疗。惩教系统中唯一标识的个人 补充巴西队列，因为与IVDU相关的急性丙型肝炎并不常见 发生在我们的巴西患者身上。此外，我们的目标是分析探索 种族因素对丙型肝炎病毒感染的影响。因此，这两个群体将允许我们 探讨丙型肝炎病毒感染的危险因素对急性丙型肝炎病毒感染免疫学的影响。

Hepatitis C virus (HCV) infects approximately 20-40% of the millions of incarcerated individuals in the United States. While many studies have characterized the seroincidence of chronic HCV infection, none have specifically addressed the issue of acute HCV infection. Since incarceration is associated with new onset intravenous drug use, such individuals would be at high risk for acute HCV infection. Screening of high-risk populations will shed insight into the incidence and clinical course of individuals and allow for characterization of their immune responses. Moreover, treatment outcomes for HCV are far better when treating early in infection, therefore identification of individuals with acute HCV is of extreme clinical benefit due to the greatly enhanced possibility of viral eradication. Interventions such as counseling, safe-needle techniques, and immunizations against hepatitis A and hepatitis B virus are also necessary. Without any systematic approach, preliminary efforts have identified 19 cases of acute HCV identified from 2 populations of incarcerated individuals over a 30-month period. This project aims to improve the identification of such subjects within the Massachusetts correctional system, describe their clinical courses, while providing access to counseling, education, and treatment for the identified individuals. Individuals identified in the correctional system uniquely complement the Brazilian cohort, since acute HCV associated with IVDU is not a frequent occurrence in our Brazilian patients. Moreover, we aim to analyze differences that explore the influence of race on the presentation of HCV. Therefore, the two cohorts will allow us to address the impact of risk factor for HCV acquisition on the immunology of acute HCV infection.