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
- 280 Downloads
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.
KeywordsViral hepatitis Co-infections Correctional facilities
The authors would like to thank Stephanie Neitzel for her thoughtful review of this manuscript and Annemarie Wasley for calculating the age-specific HCV prevalence using NHANES data of Division of Viral Hepatitis, CDC, and Joe Goldenson, Director/Medical Director Jail Health Services San Francisco Department of Public Health, and Fikirte Wagaw, Director of Community Based Services, Chicago Department of Public Health for information on the current vaccination policy from the jail study sites.
None. CDC funds were used to conduct this study.
Conflict of Interest
None of the authors has any commercial interest or other association that might pose a possible conflict of interest.
- 1.Bureau of Justice Statistics. Prison and jail inmates at midyear 2005. US Department of Justice. 2006.Google Scholar
- 4.Bureau of Justice Statistics. Drug Use and Dependence, State and Federal Prisoners, 2004. US Department of Justice. 2006.Google Scholar
- 5.Williams I, Boaz K, Openo K, et al. Missed Opportunities for Hepatitis B Vaccination in Correctional Settings, Sexually Transmitted Disease (STD) Clinics, and Drug Treatment Programs. Paper presented at: Annual Meeting of the Infectious Disease Society of America, San Francisco, CA 2005.Google Scholar
- 6.National Intitute of Corrections. Jail crowding: understanding jail population dynamics. US Department of Justice. 2002.Google Scholar
- 7.CDC. Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. MMWR Morb Mortal Wkly Rep. 2003;52:1–16.Google Scholar
- 8.CDC. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1998;47:1–39.Google Scholar
- 11.CDC. Screening for chronic hepatitis B among Asian/Pacific Islander populations—New York City, 2005. MMWR Morb Mortal Wkly Rep. 2006;55:505–509.Google Scholar
- 15.CDC. Hepatitis B vaccination of inmates in correctional facilities–Texas, 2000–2002. MMWR Morb Mortal Wkly Rep. 2004;53:681–683.Google Scholar
- 17.Mast EE, Weinbaum CM, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep. 2006;55:1–33.PubMedGoogle Scholar
- 28.Billah K, Weinbaum C, Culver D, Fiore A, Finelli L, Stokley S. Trends in self-reported hepatitis B vaccine coverage rates among adults in the United States, 2000–2002. Paper presented at: National Immunization Conference, Atlanta, Georgia 2005.Google Scholar
- 29.CDC. Update: recommendations to prevent hepatitis B virus transmission—United States. MMWR. 1999;48:33–34.Google Scholar
- 31.Spaulding A, Greene C, Davidson K, Schneidermann M, Rich J. Hepatitis C in state correctional facilities. Prev Med. 1999;28:92–100.Google Scholar
- 32.Pisu M, Meltzer M, Lyerla R. Cost-effectiveness of hepatitis B vaccination of prison inmates. In: Margolis HS, Alter MJ, Liang TJ, Dienstag JL, eds. Viral Hepatitis and Liver Disease. London: International Medical Press; 2002:236–238.Google Scholar