New hepatitis C virus infection, re-infection and associated risk behaviour in male Irish prisoners: a cohort study, 2019

Abstract

Background Prisoners are recognised as a high-risk population and prisons as high-risk locations for the transmission of hepatitis c virus (HCV) infection. Injecting drug use (IDU) is the main driver of HCV infection in prisoners and harm reduction services are often suboptimal in prison settings. HCV prevalence and incident data in prisoners is incomplete which impacts the public health opportunity that incarceration provides in identifying, treating and preventing HCV infection. The aim of this study is to identify new HCV infection and associated risk factors in an Irish male prison. Methods We conducted a follow up (18-month) cohort study on prisoners who had previously tested negative, self-cleared or had been successfully treated for HCV infection. We conducted the study in a male medium security prison located in Dublin Ireland (Mountjoy Prison) using HCV serology, a review of medical records and a researcher-administered questionnaire. Results 99 prisoners with a mean age of 33.2 yrs. participated in the study and 82(82.8%) completed a research-administered questionnaire. Over half (51%) had a history of drug use from a young age (14.8 yrs.), 49.9% a history of heroin use and 39% a history of IDU. The prevalence of HIV and hepatitis B virus core antibody was 3% and HCV antibody was 22.2%. No new HCV infections were identified in those who had never been infected (n = 77), had self-cleared (n = 9) or achieved sustained virological response (n = 12). Small numbers of prisoners continued to engage in risk-behaviour including, IDU both in the prison (n = 2) and the community (n = 3), sharing syringes (n = 1) and drug taking paraphernalia (n = 6) and receiving non-sterile tattoos (n = 3). Conclusion Despite the high numbers of Irish prisoners with a history of IDU and HCV infection, new HCV infection is low or non-existent in this population. Small numbers of prisoners continue to engage in risk behaviour and larger studies are required to further understand HCV transmission in this cohort in an Irish and international context.

Hepatitis B and hepatitis C virus infections and associated factors among prisoners in Gondar City, Northwest Ethiopia

“…This study indicates that having a body tattoo is an important risk factor for both HBV and HCV infections. Similar findings of a significant association between having a body tattoo and HBV or HCV infections have been documented by other investigators as well [ 25 , 43 , 56 , 60 ]. Tattooing in prisons often involves the use of unsterile equipment, which poses a potential risk for the transmission of blood-borne infections [ 61 ].…”

Identification of Clinical and Tumor Microenvironment Characteristics of Hypoxia-Related Risk Signature in Lung Adenocarcinoma

“…The hypoxia-related risk signature consists of eight hypoxia-related genes, including LDHA, DCN, PGK1, PFKP, FBP1, LOX, ENO3, and CXCR4. LDHA is an enzyme that catalyzes the mutual conversion of pyruvate and lactic acid, as well as promotes invasion, metastasis, nest loss, and apoptosis resistance in various cancers ( Cheng et al, 2021 ; Crowley et al, 2021 ; Gupta et al, 2021 ). Multiple studies have suggested that DCN can suppress lung cancer progression by blocking receptor tyrosine kinases ( Horvath et al, 2014 ).…”

Incidence of hepatitis C virus infection in the prison setting: The SToP‐C study

“…Most available prison-based cohort studies evaluating HCV incidence are old or limited by small study population size, or short follow-up. [7][8][9][10][11] The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study evaluated the feasibility and effectiveness of direct-acting antiviral (DAA) treatment scale-up in prisons, and demonstrated a significant reduction in HCV incidence in the period following DAA treatment scale-up. 12 The present analysis evaluated the overall HCV incidence in SToP-C prisons independent of the study period, including detailed analyses of characteristics of injecting drug use associated with the risk of HCV infection.…”

“…Despite the high HCV burden in the prison setting, data regarding HCV incidence are limited, 7 primarily due to logistical difficulties of implementing prospective studies with longitudinal follow‐up in prisons. Most available prison‐based cohort studies evaluating HCV incidence are old or limited by small study population size, or short follow‐up 7–11 …”