(P38) The Prevalence of Hepatitis C virus, Hepatitis B virus, and HIV Infection among Prisoners in Stockholm County

Författare/Medförfattare

C Gahrton[1,2], G Westman[3], K Lindahl[1,2], F Öhrn[4], O Dalgard[5, 6], C Lidman[1,2], Lars-Håkan Nilsson[7], K Said[2, 8], AS Duberg[9], S Aleman[1,2]

Affiliates

1 Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden, 2 Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden, 3 Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden, 4 Center for Innovation, Karolinska University Hospital, Stockholm, Sweden, 5 Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway, 6 Institute of Clinical Medicine, University of Oslo, Oslo, Norway, 7 The Swedish Prison and Probation Service 8 Department of Upper Gastrointestinal Diseases, Karolinska University Hospital, Stockholm, Sweden 9 Department of Infectious Diseases, School of Medical Sciences, Örebro University, Örebro, Sweden,

Abstract

Background:
It is important to find settings with high prevalence of hepatitis C virus (HCV) infection to reach the WHO goal of HCV elimination. Internationally, a high HCV prevalence has been reported among prisoners, but there are no published data from the Swedish prison population. Therefore, we aimed at determining the prevalence of viremic HCV infection in prisons in Stockholm County. Secondary aims were to determine the prevalence rates of hepatitis B virus (HBV) infection, HIV, and vaccination against HBV.

Methods:
All prisons (n=9) in Stockholm County were included in this cross-sectional study. Prisoners are routinely offered opt-in testing for HCV, HBV, and HIV in Sweden. A nurse from the Swedish Prison and Probation Service collected the testing results and the number of HBV vaccine doses received from the prison records. The prevalence rates of HCV RNA, anti-HCV, and occurrence of testing for HCV were analysed in separate multiple logistic regression models in relation to age, sex and prison security status.

Results:
Among 667 incarcerated persons the proportions tested for anti-HCV, HBsAg (hepatitis B surface antigen), and HIV Ag/Ab were 71%, 70% and 71% respectively. The prevalence rates of anti-HCV, HCV RNA, HBsAg and HIV Ag/Ab were 17.0%, 11.5%, 1.9%, and 0.2%, respectively. Both HCV RNA and anti-HCV prevalence increased with age (OR 1.04 per year, p=0.001, and OR 1.05 per year, p<0.001 respectively). Older persons were also less frequently tested (OR 0.98, p=0.002).
Forty-one percent were fully HBV vaccinated, whereas 50% were susceptible or potentially susceptible to HBV infection.

Conclusions:
The prevalence of viremic HCV infection was high at 11.5% among prisoners in Stockholm County, which underlines the importance of prisoners as a target population for HCV elimination. There is a need to increase the rate of testing for blood-borne viruses and HBV vaccination coverage in Swedish prisons.

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