Incidence and risk for acute hepatitis C infection during imprisonment in Australia

Abstract

To determine hepatitis C incidence and the demographic and behavioural predictors in seronegative drug injecting prisoners. Prisoners in New South Wales, Australia who: were aged 18 years and over; reported IDU; had been continuously imprisoned; had a documented negative HCV antibody test result in prison in the last 12 months; provided written informed consent. Subjects were interviewed about their demographic characteristics and detailed risk factors for transmission prior to, and since, imprisonment. A blood sample was collected to screen for HCV antibodies by ELISA and RNA by PCR. Of 253 inmates recruited, 120 were continuously imprisoned and included in this analysis. Sixteen acquired HCV infection indicating an incidence of 34.2 per 100 person years (CI: 19.6-55.6). Risk factors for transmission included prior imprisonment, methadone treatment and greater than 10 years of education. Although the frequency of injecting was reduced in prison, 33.6% continued to inject drugs, most commonly methamphetamine, and 90% of these reported sharing injecting equipment. Prison inmates were at high risk of HCV infection, despite some reduction in high-risk behaviours and access to prevention services. To prevent HCV transmission in prisons, better prevention strategies are required.

Incident Hepatitis C Virus Genotype Distribution and Multiple Infection in Australian Prisons

“…Samples from a prospective cohort of 500 HCV seronegative high-risk inmates enrolled in the Hepatitis C Incidence and Transmission Study in prisons (HITS-p) collected between 2005 and 2013 were used in this study (31)(32)(33). Inmates were enrolled in 34 correctional centers across New South Wales, Australia.…”

“…Blood samples were collected every 6 months to screen for seroconversion and for HCV RNA positivity, and upon diagnosis of incident infection, three to six samples were collected monthly. Details of the study protocol were reported elsewhere (16,(31)(32)(33) Virological assessments. All sera were tested for HCV antibodies using the Abbott Architect anti-HCV chemiluminescent microparticle immunoassay (Abbott Diagnostics, Abbott Park, IL, USA).…”

Indigenous Australians, Intellectual Disability and Incarceration: A Confluence of Rights Violations

“…High risk behavior, especially substance abuse, is also common among prisoners. In New South Wales (NSW), 33.6% of prisoners injected drugs in prison, although only 6% reported this behavior (Dolan et al 2010;Australian Institute of Health and Welfare 2015). Eighteen and four percent of those entering and leaving prison reported sharing needles before or during their current episode of incarceration, respectively, and only 3% received replacement therapy for opioid dependence while in custody (Australian Institute of Health and Welfare 2015).…”

“…Prisoners frequently move in and out of prisons, and as well as a high proportion of prisoners having Hepatitis C on entry, the risk of infection in prison is substantial, with an incidence of 34.2 per 100 persons found in one NSW study alone (Dolan et al 2010; Australian Institute of Health and Welfare 2015; Australian Bureau of Statistics 2010). Other than asthma (25%), there is low reported diagnosis of non-communicable diseases (NCDs) in the Australian prison populace, with ten, six and four percent of prison entrants reporting ever having been diagnosed respectively with arthritis, cardiovascular disease and diabetes (Australian Institute of Health and Welfare 2015).…”

Barriers to Legal and Human Rights in Australia in the Era of HIV Treatment as Prevention

“…Imprisonment is one of the main drivers of the hepatitis C epidemic, and having ever been in prison is identified as an independent risk factor for hepatitis C infection (Maher, Chant, Jalaludin, & Sargent, 2004). High hepatitis C transmission rates make it obvious that unsafe injecting practices occur in prisons and the general community (Dolan et al, 2010). Australia, 2010aAustralia, , 2010b.…”