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. and Kinner, Stuart A. (2014) Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs. BMC Public Health, 14 1: . doi:10.1186/1471-2458-14-830


Author Snow, Kathryn J.
Young, Jesse T.
Preen, David B.
Lennox, Nicholas G.
Kinner, Stuart A.
Title Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs
Journal name BMC Public Health   Check publisher's open access policy
ISSN 1471-2458
Publication date 2014-08-11
Sub-type Article (original research)
DOI 10.1186/1471-2458-14-830
Open Access Status DOI
Volume 14
Issue 1
Total pages 7
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2015
Language eng
Formatted abstract
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
Keyword HCV
Hepatitis C virus
Incarceration
Injecting drug use
Prison
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2015 Collection
School of Medicine Publications
 
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