BMJ 2001;323:1209 ( 24 November )

Papers

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey

Jean Long, lecturer in international health and development, ^a Shane Allwright, senior lecturer in epidemiology, ^a Joseph Barry, senior lecturer in public health, ^a Sheilagh Reaper Reynolds, education officer, ^b Lelia Thornton, specialist in public health medicine, ^c Fiona Bradley, lecturer in general practice, ^a John V Parry, deputy director. ^d

^a Department of Community Health and General Practice, Trinity College Centre for Health Sciences, Adelaide and Meath Hospital incorporating the National Children's Hospital, Tallaght, Dublin 24, Republic of Ireland, ^b Drugs/AIDS service, Northern Area Health Board, Phibsboro, Dublin 7, Republic of Ireland, ^c Department of Public Health, Eastern Regional Health Authority, Dr Steevens' Hospital, Dublin 8, Republic of Ireland, ^d Sexually Transmitted and Bloodborne Virus Laboratory, PHLS Central Public Health Laboratory, London NW9 5HT

Correspondence to: S Allwright sllwrght{at}tcd.ie

Objectives: To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in entrants to Irish prisons and to examine risk factors for infection.
Design: Cross sectional, anonymous survey, with self completed risk factor questionnaire and oral fluid specimen for antibody testing.
Setting: Five of seven committal prisons in the Republic of Ireland.
Participants: 607 of the 718 consecutive prison entrants from 6 April to 1 May 1999.
Main outcome measures: Prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in prison entrants, and self reported risk factor status.
Results: Prevalence of antibodies to hepatitis B core antigen was 37/596 (6%; 95% confidence interval 4% to 9%), to hepatitis C virus was 130/596 (22%; 19% to 25%), and to HIV was 12/596 (2%; 1% to 4%). A third of the respondents had never previously been in prison; these had the lowest prevalence of antibodies to hepatitis B core antigen (4/197, 2%), to hepatitis C (6/197, 3%), and to HIV (0/197). In total 29% of respondents (173/593) reported ever injecting drugs, but only 7% (14/197) of those entering prison for the first time reported doing so compared with 40% (157/394) of those previously in prison. Use of injected drugs was the most important predictor of antibodies to hepatitis B core antigen and hepatitis C virus.
Conclusions: Use of injected drugs and infection with hepatitis C virus are endemic in Irish prisons. A third of prison entrants were committed to prison for the first time. Only a small number of first time entrants were infected with one or more of the viruses. These findings confirm the need for increased infection control and harm reduction measures in Irish prisons.

What is already known on this topic High rates of using injected drugs, initiation of use of injected drugs, and sharing injecting equipment occur in Irish prisons Injecting drug users have high rates of infection with hepatitis B and C viruses, and hepatitis C is endemic in injecting drug users and in Irish prisoners What this study adds The prevalence of antibodies to hepatitis B core antigen, to hepatitis C, and to HIV in prison entrants who had previously been imprisoned was similar to that found in the recent national survey of Irish prisoners, but the prevalence of these antibodies was much lower in the third of prison entrants who had never previously been in prison Tattooing in prison is an independent risk factor for hepatitis C infection in prisoners who have never used injected drugs

---

© BMJ 2001
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Infections and risk factors in entrants to Irish prisons

Sarman Singh, Oscar Simooya, and Nawa Sanjobo
BMJ 2002 324: 850. [Extract] [Full Text]

Bloodborne infections in Irish prisoners are linked to drug injection and previous imprisonment
BMJ 2001 323: 0. [Full Text]

This article has been cited by other articles:

• Vescio, M F, Longo, B, Babudieri, S, Starnini, G, Carbonara, S, Rezza, G, Monarca, R (2008). Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis. J. Epidemiol. Community Health 62: 305-313 [Abstract] [Full text]  
• Poulin, C. MSc, Alary, M. MD PhD, Lambert, G. MD, Godin, G. PhD, Landry, S. MA, Gagnon, H. MA, Demers, E. MSc, Morarescu, E. MD MSc, Rochefort, J. MSc, Claessens, C. MSc (2007). Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons. CMAJ 177: 252-256 [Abstract] [Full text]  
• Comiskey, C., Saris, J., Pugh, J. (2007). Estimating the prevalence of opiate use in Ireland and the implications for the criminal justice system. Probation Journal 54: 22-35 [Abstract]  
• Hammett, T. M. (2006). HIV/AIDS and Other Infectious Diseases Among Correctional Inmates: Transmission, Burden, and an Appropriate Response. AJPH 96: 974-978 [Abstract] [Full text]  
• Feron, J M, Paulus, D, Tonglet, R, Lorant, V, Pestiaux, D (2005). Substantial use of primary health care by prisoners: epidemiological description and possible explanations. J. Epidemiol. Community Health 59: 651-655 [Abstract] [Full text]  
• Krain, A., Wisnivesky, J. P., Garland, E., McGinn, T. (2004). Prevalence of Human Immunodeficiency Virus Testing in Patients With Hepatitis B and C Infection. Mayo Clin Proc. 79: 51-56 [Abstract]  
• Jamieson, I (2002). Broad statements do not tell whole story of prison medicine. BMJ 325: 1422-1422 [Full text]  
• Singh, S., Simooya, O., Sanjobo, N. (2002). Infections and risk factors in entrants to Irish prisons. BMJ 324: 850-850 [Full text]  

Rapid Responses:

Read all Rapid Responses

Prisons and infectious diseases - time for a robust response

Oscar Simooya, et al.
bmj.com, 27 Nov 2001 [Full text]

Tattooing and hepatitis C infection

Tweg Abraham
bmj.com, 28 Nov 2001 [Full text]

Failure to control for duration of injecting causes results to be misleading

Bobby Smyth
bmj.com, 11 Dec 2001 [Full text]

High prevalence of viral and other sexually transmitted diseases in Indian prisons

Sarman Singh
bmj.com, 19 Dec 2001 [Full text]

Web versus printed version of BMJ papers

Jean Long, et al.
bmj.com, 8 Jan 2002 [Full text]

Power analysis

Susanne Habicht
bmj.com, 29 Mar 2002 [Full text]

Online poll

Find out more on doc2doc >>