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Søholm J, Holm DK, Mössner B, Madsen LW, Hansen JF, Weis N, Sauer AP, Awad T, Christensen PB. Incidence, prevalence and risk factors for hepatitis C in Danish prisons. PLoS One 2019; 14:e0220297. [PMID: 31348813 PMCID: PMC6660074 DOI: 10.1371/journal.pone.0220297] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/12/2019] [Indexed: 12/17/2022] Open
Abstract
Hepatitis C virus (HCV) infection is prevalent among people in prison and prisons could therefore represent a unique opportunity to test risk groups for HCV. The aim of this sero-epidemiological study was to determine the incidence and prevalence of HCV infection and the corresponding risk factors in Danish prisons. Participants, recruited from eight Danish prisons, were tested for HCV using dried blood spots and filled out a questionaire with demographic data and risk factors for HCV infection. In total, 76.9% (801/1041) of all eligible prisoners consented to participate. The prevalence of HCV RNA positive prisoners was 4.2% (34/801) and the in-prison incidence rate was 0.7–1.0 per 100PY overall and 18-24/100PY among PWIDs. Infected prisoners were older than the overall population with a mean age of 42 years and only 17.6% (6/34) were younger than 35 years. The prevalence of PWID was 8.5% (68/801) and only 3% (2/68) of PWID were younger than 25 years. Among the PWID, 85.3% (58/68) had ever received opioid substitution therapy (OST) and 47.1% (32/68) were currently receiving OST. Risk factors associated with HCV infection were intravenous drug use, age ≥ 40 years, and being incarcerated ≥ 10 years. In conclusion, the prevalence of PWID in Danish prisons is low, possibly reflecting a decrease in injecting among the younger generation. This together with OST coverage could explain the low prevalence of HCV infection. However among PWIDs in prison the incidence remains high, suggesting a need for improved HCV prevention in prison.
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Affiliation(s)
- Jacob Søholm
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | | | - Belinda Mössner
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Lone Wulff Madsen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Janne Fuglsang Hansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Nina Weis
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Tahany Awad
- Medical Affairs, AbbVie A/S, Copenhagen, Denmark
| | - Peer Brehm Christensen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
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Understanding the Syndemic Connections Between HIV and Incarceration Among African American Men, Especially African American Men Who Have Sex with Men. SOCIAL DISPARITIES IN HEALTH AND HEALTH CARE 2016. [DOI: 10.1007/978-3-319-34004-3_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Freitas SZ, Teles SA, Lorenzo PC, Puga MAM, Tanaka TSO, Thomaz DY, Martins RMB, Druzian AF, Lindenberg ASC, Torres MS, Pereira SA, Villar LM, Lampe E, Motta-Castro ARC. HIV and HCV coinfection: prevalence, associated factors and genotype characterization in the Midwest Region of Brazil. Rev Inst Med Trop Sao Paulo 2015; 56:517-24. [PMID: 25351547 PMCID: PMC4296873 DOI: 10.1590/s0036-46652014000600011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 04/29/2014] [Indexed: 12/19/2022] Open
Abstract
A cross-sectional study on prevalence, associated factors and genotype
distribution of HCV infection was conducted among 848 HIV-infected patients
recruited at reference centers in the Midwest Region of Brazil. The prevalence
rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6).
In multivariable analysis, increasing age, use of illicit drugs (injection
and non-injection), a history of blood transfusion before 1994, and the
absence of a steady partnership were significant independent associated factors
for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region
revealed the presence of two major circulating genotypes of HCV: genotypes 1
(58.3%) and 3 (41.7%). The prevalence of HIV-HCV
coinfection was lower than those reported in studies conducted with HIV-infected
patients in different regions of Brazil, due to the fact that illicit drug use
is not a frequent mode of HIV transmission in this region of Brazil. Serologic
screening of HIV-patients for HCV before initiating antiretroviral treatment, a
comprehensive identification of associated factors, and the implementation of
effective harm reduction programs are highly recommended to provide useful
information for treatment and to prevent HCV coinfection in these patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Marina Sawada Torres
- Hematology and Hemotherapy Center of Mato Grosso do Sul, Campo Grande, MS, Brazil
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McLaughlin MM, Chow EPF, Wang C, Yang LG, Yang B, Huang JZ, Wang Y, Zhang L, Tucker JD. Sexually transmitted infections among heterosexual male clients of female sex workers in China: a systematic review and meta-analysis. PLoS One 2013; 8:e71394. [PMID: 23951153 PMCID: PMC3741140 DOI: 10.1371/journal.pone.0071394] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 06/29/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Female sex workers have been the target of numerous sexually transmitted infection (STI) prevention strategies in China, but their male clients have attracted considerably less public health attention and resources. We sought to systematically assess the prevalence of HIV, syphilis, gonorrhea, and chlamydia among heterosexual male clients of female sex workers in China. METHODS/PRINCIPAL FINDINGS Original research manuscripts were identified by searching Chinese and English language databases, and 37 studies analyzing 26,552 male clients were included in the review. Client STI prevalence across studies was heterogeneous. Pooled prevalence estimates and 95% confidence intervals were 0.68% (0.36-1.28%) for HIV, 2.91% (2.17-3.89%) for syphilis, 2.16% (1.46-3.17%) for gonorrhea, and 8.01% (4.94-12.72%) for chlamydia. CONCLUSIONS/SIGNIFICANCE The pooled prevalence estimates of HIV, syphilis, gonorrhea, and chlamydia among clients in this review exceed the prevalences previously reported among population-representative samples and low-risk groups in China. However, heterogeneity across studies and sampling limitations prevent definitive conclusions about how the prevalence of STIs in this population compares to the general population. These findings suggest a need for greater attention to clients' sexual risk and disease prevalence in China's STI research agenda in order to inform effective prevention policies.
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Affiliation(s)
| | - Eric P. F. Chow
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Cheng Wang
- Guangdong Provincial Center for STI & Skin Diseases Control, Guangzhou, China
| | - Li-Gang Yang
- Guangdong Provincial Center for STI & Skin Diseases Control, Guangzhou, China
| | - Bin Yang
- Guangdong Provincial Center for STI & Skin Diseases Control, Guangzhou, China
| | - Jennifer Z. Huang
- Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, District of Columbia, United States of America
| | - Yanjie Wang
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Lei Zhang
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Joseph D. Tucker
- UNC Project – China, Guangzhou, China
- Guangdong Provincial Center for STI & Skin Diseases Control, Guangzhou, China
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