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Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs
BACKGROUND: Hepatitis C virus (HCV) infection is common among prisoners, particularly those with a history of injecting drug use (IDU). Incarcerated people who inject drugs frequently report high-risk injecting practices both in prison and in the community. In spite of rising morbidity and mortality...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137068/ https://www.ncbi.nlm.nih.gov/pubmed/25113132 http://dx.doi.org/10.1186/1471-2458-14-830 |
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author | Snow, Kathryn J Young, Jesse T Preen, David B Lennox, Nicholas G Kinner, Stuart A |
author_facet | Snow, Kathryn J Young, Jesse T Preen, David B Lennox, Nicholas G Kinner, Stuart A |
author_sort | Snow, Kathryn J |
collection | PubMed |
description | BACKGROUND: Hepatitis C virus (HCV) infection is common among prisoners, particularly those with a history of injecting drug use (IDU). Incarcerated people who inject drugs frequently report high-risk injecting practices both in prison and in the community. In spite of rising morbidity and mortality, utilisation of HCV-related services in Australia has been persistently low. This study aimed to describe the incidence, prevalence and correlates of HCV seropositivity in a large cohort of prisoners who have injected drugs, and to identify correlates of receiving confirmation of active infection. METHODS: Data-linkage to a State-wide statutory notifiable diseases surveillance system was used to investigate the incidence of notified HCV seropositivity, seroconversion and confirmed HCV infection in a cohort of 735 prisoners with a history of IDU, over 14 years of follow up. Hepatitis C test results from prison medical records were used to identify correlates of testing positive in prison. RESULTS: The crude incidence of HCV notification was 5.1 cases per 100 person-years. By the end of follow up, 55.1% of the cohort had been the subject of a HCV-related notification, and 47.4% of those tested in prison were HCV seropositive. In multivariable analyses, injecting in prison was strongly associated with HCV seropositivity, as was opioid use compared to injection of other drugs. The rate of reported diagnostic confirmation among those with notified infections was very low, at 6.6 confirmations per 100 seropositive participants per year. CONCLUSIONS: Injecting drugs in prison was strongly associated with HCV seropositivity, highlighting the need for increased provision of services to mitigate the risk of transmission within prisons. Once identified as seropositive through screening, people with a history of IDU and incarceration may not be promptly receiving diagnostic services, which are necessary if they are to access treatment. Improving access to HCV-related services will be of particular importance in the coming years, as HCV-related morbidity and mortality is increasing, and next generation therapies are becoming more widely available. |
format | Online Article Text |
id | pubmed-4137068 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41370682014-08-19 Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs Snow, Kathryn J Young, Jesse T Preen, David B Lennox, Nicholas G Kinner, Stuart A BMC Public Health Research Article BACKGROUND: Hepatitis C virus (HCV) infection is common among prisoners, particularly those with a history of injecting drug use (IDU). Incarcerated people who inject drugs frequently report high-risk injecting practices both in prison and in the community. In spite of rising morbidity and mortality, utilisation of HCV-related services in Australia has been persistently low. This study aimed to describe the incidence, prevalence and correlates of HCV seropositivity in a large cohort of prisoners who have injected drugs, and to identify correlates of receiving confirmation of active infection. METHODS: Data-linkage to a State-wide statutory notifiable diseases surveillance system was used to investigate the incidence of notified HCV seropositivity, seroconversion and confirmed HCV infection in a cohort of 735 prisoners with a history of IDU, over 14 years of follow up. Hepatitis C test results from prison medical records were used to identify correlates of testing positive in prison. RESULTS: The crude incidence of HCV notification was 5.1 cases per 100 person-years. By the end of follow up, 55.1% of the cohort had been the subject of a HCV-related notification, and 47.4% of those tested in prison were HCV seropositive. In multivariable analyses, injecting in prison was strongly associated with HCV seropositivity, as was opioid use compared to injection of other drugs. The rate of reported diagnostic confirmation among those with notified infections was very low, at 6.6 confirmations per 100 seropositive participants per year. CONCLUSIONS: Injecting drugs in prison was strongly associated with HCV seropositivity, highlighting the need for increased provision of services to mitigate the risk of transmission within prisons. Once identified as seropositive through screening, people with a history of IDU and incarceration may not be promptly receiving diagnostic services, which are necessary if they are to access treatment. Improving access to HCV-related services will be of particular importance in the coming years, as HCV-related morbidity and mortality is increasing, and next generation therapies are becoming more widely available. BioMed Central 2014-08-11 /pmc/articles/PMC4137068/ /pubmed/25113132 http://dx.doi.org/10.1186/1471-2458-14-830 Text en © Snow et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Snow, Kathryn J Young, Jesse T Preen, David B Lennox, Nicholas G Kinner, Stuart A Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs |
title | Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs |
title_full | Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs |
title_fullStr | Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs |
title_full_unstemmed | Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs |
title_short | Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs |
title_sort | incidence and correlates of hepatitis c virus infection in a large cohort of prisoners who have injected drugs |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137068/ https://www.ncbi.nlm.nih.gov/pubmed/25113132 http://dx.doi.org/10.1186/1471-2458-14-830 |
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