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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Kimberly Page-Shafer, PhD, MPH1, Susan Currie, MA1, Nancy Moss, PhD1, Rena Fox, MD2, Teresa L Wright, MD3, Leslie Tobler, PhD4, Bruce Phelps, PhD5, Michael P Busch, MD, PhD4, Peter Dailey, PhD5, and Jennifer Evans, MS6. (1) Department of Medicine, University of California Center for AIDS Prevention Studies, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105, 415/597-4954, shafer@psg.ucsf.edu, (2) Department of Medicine, University of California, San Francisco, UCSF, Box 0320/400 Parnassus Ave, 4th Fl, San Francisco, CA 94143, (3) UCSF, Box 111B, VAMC 203, San Francisco, CA 94143, (4) Blood Centers of the Pacific, 270 Masonic Avenue, San Francisco, CA 94118, (5) Chiron, 4560 Horton Street, Emeryville, CA 94608, (6) Department of Epidemiology & Biostatistics, University of California, San Francisco, 74 New Montgomery St Suite 600, San Francisco, CA 94105
BACKGROUND: Drug and drug-related crime have been associated with a significant increase in the correctional population in California and hepatitis C virus (HCV) infection is believed to be prevalent in up to 40% of inmates. Previous research in California prisons have not extensively examined risk factors associated with HCV. Significant public health resources may be required to address HCV education and prevention among incarcerated populations and in the communities in which they return to upon release.
OBJECTIVE: To determine prevalence and independent correlates of HCV infection among inmates entering California correctional facilities.
METHODS: We recruited a cross-sectional sample of inmates entering 3 California correctional facilities. 472 subjects consented and interviewed. Blood samples were tested and confirmed for HCV antibody (anti-HCV). Negative samples were tested for HCV RNA to detect viremic seronegative (incident) infections (Chiron/GenProbe).
RESULTS: Prevalence of anti-HCV was 39% among females and 32% among males; 18% among African-Americans (Af-Am), 39% among Latinos, and 47% among Whites (p<0.001). Median time of incarceration history was 5.0 years. 38% reported being previously tested for anti-HCV. One viremic seronegative (incident) infection was detected. HCV was independently associated with race (Latino vs. Af-Am (OR 3.9, 95% CI, 1.4 - 10.7), and any history of injection drug use (IDU) (OR 13.7, 95% CI, 13.7-26.4), controlling for age. Among those with no history of IDU, anti-HCV was associated with time of incarceration history (per 5 year increase) (OR 1.1, 95% CI, 1.0-1.2).
CONCLUSION: A high prevalence of HCV was detected in persons entering prison, the majority of whom were not aware of their infection status. Almost all HCV infections represent established rather than incident infections. These data confirm that the majority of HCV in correctional institutions are attributable to a history of IDU. HCV infection among inmates who reported no history of incarceration was more likely among those with a longer history of incarceration. Health education programs provided to prison populations should include instruction on HCV prevention in correctional institutions and to community members upon release.
Learning Objectives: LEARNING OBJECTIVES
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.