Risk factors for monoinfections and coinfections with HIV,hepatitis B and hepatitis C viruses in northern Spanish prisoners.

A cross-sectional study was conducted in prisons of Cantabria (northern Spain) from June 1992 to December 1994. Inmates were asked to participate in a survey on prevalence and risk factors for monoinfections and coinfections with HIV, HBV and HCV. Crude and multiple odds ratios of risk factors were calculated (by polychotomous logistic regression). Prevalence of coinfections was higher than that of monoinfections. IDU risk factors were the main independent variables associated with monoinfections and coinfections with these agents. The strength of association increased with the degree of coinfection for IDU risk factors and penal status, e.g. duration of injecting drug use for more than 5 years yielded an adjusted OR ranging from 1.3 (95% CI: 0.4-5.1) for HBV monoinfection to 180 (95% CI: 61.0-540.0) for HIV-HBV-HCV coinfection. In comparison, sexual behaviours were less important than IDU risk factors.     

Prevalence of HIV,syphilis, hepatitis B,and hepatitis C among entrants to Maryland correctional facilities

Although high prevalence of hepatitis C virus (HCV) in correctional institutions has been established, data are sparse regarding the comorbidities of hepatitis B virus (HBV), HCV, and human immunodeficiency virus (HIV), all of which may complicate the management of HCV. This study sought to estimate the prevalence and correlates associated with HCV prevalence among entrants into the Maryland Division of Correction and the Baltimore City Detention Center. Participants included all newly incarcerated entrants between January 28 and March 28, 2002. Excess sera with identifiers removed from samples drawn for routine syphilis testing were assayed for antibodies to HIV and HCV and for HBV surface antigen and surface and total core antibodies. Separately, all HIV-positive specimens were tested using the serological testing algorithm for recent HIV seroconversion. Of the 1,081 immates and 2,833 detainees, reactive syphilis serology was noted in 0.6% of the combined population; HIV seroprevalence was 6.6%; HCV prevalence was 29.7%; and 25.2% of detainees and prisoners had antigen or core or surface antibodies to HBV. A multivariate analysis of predictors of HCV positivity indicated that detainees, women, whites, older age groups, those who were HIV seropositive, and individuals with past or present infection with HBV were significantly more likely to be positive for HCV. These data indicate that hepatitis C remains an important public health concern among entrants to jail and prison and is complicated with coinfections that need to be addressed for effective treatment.     

浙江省台州市HIV感染者中HBV和HCV及EBV合并感染率研究

目的探讨浙江省台州市人类免疫缺陷病毒(HIV)感染者中乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)及EB病毒(EBV)合并感染率,并分析其影响因素。方法对台州市所有可定期随访的167例HIV感染者进行流行病学调查,其中男性113例,女性54例;平均年龄40岁。采用ELISA方法检测确定其HBV、HCV和EBV的血清阳性率。利用单因素logistic回归模型分析数据。结果研究经异性性接触感染HIV 115例(68.9%)。HBV、HCV、EBV的感染率分别为7.2%、21.0%和93.4%;有2例HIV感染者同时感染了HBV、HCV、EBV等3种病毒;有35例(21.0%)HIV感染者同时感染了HCV和EBV。单因素logistic回归分析显示:HIV感染者中,农民的HBV感染率高于从事商业服务者,经血液途径感染HIV者的HCV感染率高于经性途径感染HIV者,已婚者的EBV感染率高于未婚者。结论当地HIV感染者中存在一定比例的HBV、HCV和EBV共感染者,不同特征的HIV感染者中HBV、HCV和EBV的共感染率不同。     

Seroprevalence of markers for hepatitis B, C and G in male and female prisoners - NSW, 1996

OBJECTIVES: 1. Establish the prevalence of markers for hepatitis B (HBV), C (HCV) and G (HGV) in a sample of male and female inmates. 2. Examine exposure to multiple viruses. 3. Compare risk factors for HGV infection with known risk factors for HBV and HCV. DESIGN: Cross-sectional random sample stratified by sex, age and Aboriginality. Inmates were screened for three hepatitis markers. Participants were 789 inmates (657 male, 132 female) in 27 correctional centres in New South Wales, 1996. RESULTS: Overall detection of each of the three screening markers was 35% for HBV, 39% for HCV and 10% for HGV. Exposure rates were higher in female prisoners than males. Increased rates of anti-HBc were observed in Aboriginal inmates compared with non-Aboriginals (54% cf. 27%); anti-HCV and HGV-RNA were comparable between the two groups (36% cf. 41% and 9% cf. 10%). Markers were significantly higher in female injecting drug users (IDU), particularly HCV (90% cf. 66%). Thirty-five per cent of inmates were unaware of their HCV status. For HBV, 72% did not self-report past or present exposure despite serological evidence to the contrary. The multivariate analysis identified Aboriginality, long-term injecting and injecting while in prison as risk factors for HBV. HCV risk factors were female sex, non-Aboriginality, institutionalisation and IDU-associated behaviours. For HGV, female sex and previous imprisonment were significant risk factors but IDU was not. CONCLUSIONS: Blood-borne hepatitis viruses are common in prison inmates, particularly females (HBV, HCV and HGV), Aboriginals (HBV) and IDU (HBV and HCV). Infection can be related to a number of risk factors, which appear similar for HBV and HCV, but distinct from HGV.     

Measures to reduce HIV infection have not been successful to reduce the prevalence of HCV in intravenous drug users

The objective of the study was to determine whether measures taken to prevent human immunodeficiency virus (HIV) infection also lead to a reduction in the prevalence of hepatitis C virus (HCV) infection among intravenous drug users (IDU). Antibodies to HCV, HIV and hepatitis B virus (HBV) were determined in IDU who voluntarily attended AIDS prevention and information centres for the first time between 1990 and 1996. Of the 5473 IDU studied, determination of HCV was done in 3238 cases. The prevalence of antibodies to HCV was 85%. During the first period studied (1990–1992), the prevalence of antibodies to HCV was 84.5%, during the second (1993–1994) 84.1% and during the third (1995–1996) 87%; in the case of HBV the prevalence during the three periods was 74.5, 67.6 and 66.8% respectively, and for HIV it was 41.9, 38.8 and 36.6% respectively (RR: 0.72; 95% confidence interval (CI): 0.65–0.81). Among drug users addicted for less than 2 years, the trend of the prevalence of antibodies to HCV and HBV remained constant, while the prevalence of HIV infection decreased (RR: 0.61; 95% CI: 0.42–0.89). Measures to prevent transmission of HIV in drug users do not lead to a reduction in the prevalence of HCV infection. Further study is necessary to obtain a better understanding of how HCV is transmitted among drug users in order to apply measures which are effective in preventing HCV infection.     

Prevalence of serologic markers of HBV, HDV, HCV and HIV in non-injection drug users compared to injection drug users in Gran Canaria, Spain

Injection drug use (IDU) is one of the most significant risk factors for viral hepatitis (B, D and C) and human immunodeficiency virus (HIV) infection. However, there is little information about the risk of infection among non-injection drug users (non-IDUs). The present study was designed to perform several objectives: (a) to evaluate the prevalence of serological markers of hepatitis B, D, C virus and HIV in IDU and non-IDU patients; (b) to compare the prevalence of these markers between both groups; (c) to identify risk factors for HCV and HIV in this population; and (d) to correlate the presence of HCV and liver function. A total of 385 consecutive patients (122 IDUs and 263 non-IDUs), admitted to the Drug Dependency Treatment Unit at the Hospital Insular of Gran Canaria between 1993 to 1994, were included in the study. The serological markers of HBV, HDV, HCV and HIV were determined by ELISA and immunoblot methods. In all cases we also measured syphilis tests (RPR and FTAabs), serum aminotransferases and serum gammaglutamiltranspeptidase. Compared to the non-IDU, the IDU group presents a higher prevalence of antiHBc (55.0% vs. 20.7%, p < 0.0001), antiHCV (87.6% vs. 35.3%, p < 0.0001) and antiHIV (21.8% vs. 2.7%, p < 0.0001). There was no significant difference in RPR positivity (0.9% vs. 4.9%, p = 0.06). Delta infection was only detected in injection drug users, and the prevalence was low. Using logistic regression, the only risk factors associated with antiHCV positivity were injection drug addiction (OR: 9.2, 95% CI: 4.9–17.0) and antiHBc positivity (OR: 5.5, 95% CI: 3.0–9.9). Similarly, the associated risk factors for HIV were injection drug addiction (OR: 5.9, 95% CI: 2.3–15.0) and antiHBc positivity (OR: 3.8, 95% CI: 1.5–9.2). However, no correlation was found between antiHCV positive and antiHIV or between these markers and RPR positivity. Patients positive for antiHCV showed significant elevations in aspartate aminotransferase and alanine aminotransferase levels, when compared with patients negative for antiHCV: 65.0 vs. 39.2 U.l (p < 0.001) and 88.4 vs. 40.3 U/l (p < 0.001), respectively. We conclude that drug users have an elevated prevalence of HCV, HBV and HIV infection, even if drug use is only inhalated. On the other hand, the main risk factors associated with HCV and HIV are injection drug addiction and exposure to hepatitis B virus. Finally, in the study population, liver dysfunction is closely related to HCV infection.     

Prevalence and Correlates of HCV,HVB, and HIV Infection among Prison Inmates and Staff,Hungary

The aim of this national, multicenter, cross-sectional study was to assess the prevalence of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency viruses (HIV) among prisoners, and to identify related risk behaviors including injection drug use. Overall, 4,894 inmates from 20 prisons were enrolled. To have a comparison group, prison staff were also asked to take part. Altogether, 1,553 of the 4,894 inmates from seven prisons completed a questionnaire on risk behaviors. According to the survey, 1.5%, 4.9%, and 0.04% of the prisoners were tested positive for HBsAg, anti-HCV and anti-HIV, respectively. These prevalence data are among the lowest reported from prisons worldwide, although comparable to the Central European data. The prevalence of HBV, HCV, and HIV in the Hungarian prison staff was low (0.38%, 0.47%, and 0%, respectively). The rate of HCV infection was significantly higher among inmates who have ever injected drugs (22.5%) than among inmates who reported they had never injected drugs (1.1%). This first prevalence study of illegal drug injection-related viral infections among Hungarian prisoners points out that ever injecting drugs is the main reason for HCV infection among inmates. The opportunity to reach drug users infected with HCV for treatment underlines the importance of screening programs for blood-borne viruses in prisons.     

Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA.

This study aimed to assess the seroprevalence and risk factors for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV-1 infections among injecting drug users (IDU) in New Mexico. Serological and behavioural surveys were conducted in conjunction with street-based outreach, education and HIV counselling and testing. High rates of antibody positivity for HCV (82.2%) and HBV (61.1%), and a low rate for HIV (0.5%) were found. In multivariate analyses, both HBV and HCV infection were positively associated with increasing age, increasing years of injection and heroin use. Receipt of a tattoo in prison/jail was associated with HBV (odds ratio = 2.3, 95% confidence interval 1.4, 3.8) and HCV (OR = 3.4, 95% CI = 1.6, 7.5) infections. Prevention of bloodborne pathogens among IDUs should focus on young users, early in their drug use experience. Studies examining the relationship between tattooing and HBV and HCV infection are needed as are efforts to promote sterile tattooing, in prisons and elsewhere.     

Prevalence of hepatitis B,hepatitis C,syphilis and HIV in Georgian blood donors

Prevalence of human immunodeficiency (HIV), hepatitis B (HBV), hepatitis C (HCV) virus and syphilis in the population of blood donors in Georgia has been investigated. Out of 4970 donors 7.3% had anti-HCV (6.9% confirmed), HbsAg was positive in 4.1% (3.4% confirmed), Seroprevalence of Syphilis was 2.3%. Three individuals had HIV. Prevalence of HCV and HBV in Georgia is higher than national prevalence estimates of viral hepatitis in neighboring countries.     

Hepatitis virus and HIV infections in inmates of a state correctional facility in Mexico

We sought to determine the prevalence and associated characteristics of hepatitis A, B, C and D viruses and HIV infections in a prison in Durango, Mexico. Sera from 181 inmates were analysed for HAV antibody, hepatitis B core antibody (HBcAb), hepatitis B surface antigen (HBsAg), HCV antibody, HDV antibody, HIV antibody and HCV genotypes. Prevalence of HAV antibody, HBcAb, HBsAg, HCV antibody, HDV antibody and HIV antibody were 99.4, 4.4, 0.0, 10.0, 0.0 and 0.6% respectively. HCV genotype 1a predominated in HCV-infected inmates (62.5%), followed by HCV genotype 1b (25%) and HCV genotype 3 (12.5%). An association between HBV infection and age > 30 years was found. HCV infection was associated with being born in Durango City, history of hepatitis, ear piercing, tattooing, drug abuse history, intravenous drug use and lack of condom use. We concluded that the prevalence of HAV, HBV, HDV and HIV infections in inmates in Durango, Mexico were comparable to those of the Mexican general population and blood donors, but lower than those reported in other prisons around the world. However, HCV infection in inmates was higher than that reported in Mexican blood donors but lower than those reported in other prisons of the world. These results have implications for the optimal planning of preventive and therapeutic measures.     

Prevalence and incidence of HIV, hepatitis B virus, and hepatitis C virus infections among males in Rhode Island prisons

OBJECTIVES: We evaluated prevalence and intraprison incidence of HIV, hepatitis B virus, and hepatitis C virus infections among male prison inmates. METHODS: We observed intake prevalence for 4269 sentenced inmates at the Rhode Island Adult Correctional Institute between 1998 and 2000 and incidence among 446 continuously incarcerated inmates (incarcerated for 12 months or more). RESULTS: HIV, hepatitis B virus, and hepatitis C virus prevalences were 1.8%, 20.2%, and 23.1%, respectively. Infections were significantly associated with injection drug use (odds ratio = 10.1, 7.9, and 32.4). Incidence per 100 person-years was 0 for HIV, 2.7 for HBV, and 0.4 for HCV. CONCLUSIONS: High infection prevalence among inmates represents a significant community health issue. General disease prevention efforts must include prevention within correctional facilities. The high observed intraprison incidence of HBV underscores the need to vaccinate prison populations.     

乙型和丙型病毒性肝炎及相关肝细胞癌的流行现况

乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染是全球主要的健康问题。全球约有3.5亿人（5%）为HBV慢性感染者,其中75%为亚洲人,而HCV的慢性感染者为1.5亿人（2%）。乙型和丙型肝炎是肝硬化和肝细胞癌（HCC）的主要危险因素,肝硬化中的57%和原发性肝癌中的78%为HBV或HCV感染引起。作者将中国、亚洲和美国的HBV、HCV和HCC的流行病学资料进行综述比较,并分析当前危险因素等。在中国和全球其他国家,HBV和HCV仍是HCC的主要危险因素,HBV疫苗的使用显著降低了HBV感染率,进而降低了HCC的患病率,而将来HCV可能取代HBV成为主要危险因素;乙醇作为肝硬化和肝癌的危险因素影响较小。     

Comparison between self-reported hepatitis B, hepatitis C, and HIV antibody status and oral fluid assay results in Irish prisoners

Self-reported hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infection status was compared with the results of oral fluid assays of antibodies to these viruses in prisoners from nine of the 15 prisons in the Republic of Ireland. A total of 1205 out of 1366 prisoners completed a confidential questionnaire and 1193 provided analysable oral fluid specimens for testing for antibodies to HBV core antigen (anti-HBc), HCV (anti-HCV), and HIV (anti-HIV). The self-reported prevalence of hepatitis infection (hepatitis B: 5%; hepatitis C: 19%) was lower than that derived from oral fluid assays (anti-HBc: 9%; anti-HCV: 37%). The self-reported prevalence of HIV infection was similar to that found by oral fluid assay (2%). Many discrepancies were found between self-reported results and the results of oral fluid assays. Of those who reported being positive for HBV, HCV, or HIV, 48%, 5%, and 58%, respectively, tested negative on the oral fluid assay. Of those who reported a previous negative test result for HBV, HCV, or HIV, 10%, 37%, and 2%, respectively, had positive oral fluid assays. Self-reports of hepatitis and HIV infection status are unreliable and should not be used as a basis for planning preventive and treatment services for prisoners. All prisoners should have the opportunity to be tested for HBV, HCV, and HIV infection.     

Prevalence of hepatitis virus infections in Albanian refugees

A sample of 393 Albanian refugees, including both children and adults, was tested for serological HAV, HBV, HDV and HCV markers. A high prevalence of infection with both the hepatitis A and B viruses was found, while HDV and HCV infections were uncommon. The overall prevalence of anti-HAV was 96%; it was very high in children 0-10 years, suggesting that HAV infection is largely acquired during childhood and that poor ambiental conditions influence the spreading of this viral infection.One or more serological markers of HBV infection were found in 295 Albanians (75%), confirming the endemic nature of this virus in the Albanian community. The overall prevalence of HBsAg was 19%, and the carrier rate was higher in males than in females. The high HBsAg prevalence among children suggests that HBV infection is usually acquired in early childhood.The serological data obtained in the Albanian sample examined clearly indicate the urgent need for measures to reduce the incidence of HAV and HBV infections and to avoid the further spread of HDV and HCV infections.Finally, the high prevalence of type B hepatitis indicates the necessity of vaccination against HBV for all risk groups and for all children at birth.     

Prevalence of hepatitis B markers in patients with hepatitis C infection in north-eastern Poland: Risk factors and vaccine use

We evaluated the prevalence of hepatitis B virus (HBV) markers and established HBV vaccination status among 111 patients with hepatitis C virus (HCV) infection. A history of HBV immunisation was recorded in 30 patients (27.0%) and only 17/30 (66.7%) had anti-HBs level 10 mIU/ml. All patients were HBsAg-negative and 22.2% of nonvaccinated subjects had evidence of HBV infection as determined by anti-HBc presence. Among patients with anti-HBc in 7/18 cases (38.9%) anti-HBc was the only marker of HBV infection (without anti-HBs). The prevalence of anti-HBc was significantly higher among patients who reported a history of acute hepatitis. In conclusion the prevalence of HBV markers in patients with HCV infection in north-eastern Poland is similar to the prevalence in general population, which suggests no increased risk for nosocomial HBV infection among those individuals. HCV infection seems to favour unusual serological pattern of HBV infection with anti-HBc as the only marker. HBV vaccine use is low among patients with HCV infection in north-eastern Poland.     

Differences in Sexual Identity,Risk Practices,and Sex Partners between Bisexual Men and Other Men among a Low-Income Drug-Using Sample

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.     

Hepatitis-C and hepatitis-B co-infections in patients with human immunodeficiency virus in Tehran, Iran

We carried out a study to determine the seroprevalence of HBV and HCV infections in HIV positive patients at a main referral center for HIV/AIDS in Iran. Serum samples from 201 HIV positive patients referring to a referral center for HIV/AIDS were analyzed for the presence of some hepatitis B (HBsAg, anti-HBc, anti-HBs) and Hepatitis C (anti-HCV) markers, during 2004- 2005. HBsAg was positive in 27 patients (13.4%), anti-HBc was positive in 60 patients (29.8%) and anti-HBs in 23 patients (11.4%). Anti-HCV Ab was positive in 135 of 201 (67.2%). HBV and HCV coinfection was observed in 73 of 201 (36.3%). The maximum prevalence of HBV-HIV and HCV-HIV coinfections were seen in intravenous drug users; 61.2% and 85.1%, respectively (P<0.0001). The minimum prevalence of HBV-HIV and HCV-HIV were seen in HIV patients' wife (HIV(+) patients who were infected by monogamous sexual contact with their HIV positive husband) both of them were 8% (P<0.0001). This study showed that HBV-HIV and HCV-HIV coinfections are significant in patients with HIV/AIDS in Iran. A greater relevance was observed in the association between HCV and HIV. This study suggests that it is necessary to investigate risk factors and risk groups for these infections in Iran.     

Detection and treatment of HIV and hepatitis virus infections in Swiss correctional facilities

OBJECTIVES: The aim of the study was to obtain an overview on diagnostic and therapeutic activities concerning hepatitis A, B, C virus and HIV in Swiss prisons. METHODS: A standardized questionnaire was sent to 91 prisons in the German and Italian speaking parts in October 2004; 41 institutions (45%) answered the questionnaire. RESULTS: In almost all prisons serological examinations were not done routinely, but were provided when demanded by inmates or recommended by the medical service. Vaccination against hepatitis A or B infection and initiation of antiviral therapy was possible in most institutions. CONCLUSIONS: Most of the prisons investigated offered diagnostic and antiviral treatment for hepatitis virus and HIV infections. A reported problem was the discontinuation of ongoing treatments or vaccination cycles after discharge. In some cases deficient funding was an obstacle.     

广东省1995～2001年HIV抗体阳性献血员合并HBV、HCV、梅毒感染状况调查

目的 了解广东省1995～2001年献血员HIV流行的特征及与其他传染病合并感染情况，为制定HIV经血源传播防治策略提供依据。方法 收集1995～2001年广东省HIV抗体阳性献血员资料进行分析，并进行HBV、HCV和梅毒血清学检测。结果 1995～2001年，广东省累计HIV抗体阳性献血员167例，占全省报告HIV感染总数的5．44％(167／3072)，且献血员中HIV抗体阳性人数逐年增长。167例病例中以男性为多(88．02％)；年龄主要集中在20～29岁组(55．09％)；病例送检地区以广州、深圳和东莞为主；其原籍主要是广东省和河南省。128例肌，抗体阳性献血员中抗-HCV、梅毒抗体及HBsAg阳性率分别为79．69％、7．81％及3．13％，HIV／HCV／梅毒、HIV／HBV／HCV、HIV／HBV／梅毒三重感染率分别为7．81％、3．13％及0，未发现四重感染。结论 广东省肌，抗体阳性献血员合并HCV和梅毒感染率高。应加强献血员的筛查及流动人口的管理，以控制HIV,HBV和HCV经献血员向一般人群传播。