Transmission of hepatitis C within Australian prisons

Abstract

Transmission of hepatitis C virus (HCV) within prisons has long been suspected but has not been satisfactorily documented. We present four cases of HCV infection occurring during periods of continuous imprisonment. Each subject was HCV seronegative on entering prison and on repeat testing after 4–52 months in prison, but subsequently became seropositive. Two subjects gave a history of injecting drug use, and the most likely means of infection in the other two subjects were lacerations from barbers shears and lacerations arising from physical assault. There is an urgent need for detailed study of the incidence of HCV infection and the modes of transmission in prisons.

Prisoners are at risk for hepatitis C transmission

“…Considering the high background prevalence of hepatitis C in prison, it is inevitable that other mechanisms leading to blood to blood contact also play a role in the transmission of hepatitis C such as the reuse of razors, barbering equipment, toothbrushes, sexual activity, and assaults [17]. Therefore, even among injecting drug users, caution should be taken in interpreting the results.…”

Developing blood borne virus services across prisons in Wales, UK

“…Activities that may take place inside prisons such as tattooing and injecting are more likely to involve reusing and sharing contraband equipment increasing the risks of BBV transmission among inmates however it is understood that the majority of prisoners with HBV, HCV or HIV acquire their infection whilst in the community (Dolan et al, 2010). Potential risks of BBV transmission may also exist through sharing razors during prison barber services (Tumminelli et al, 1995;Haber et al, 1999;Kelly, 2000). Rates of HBV in UK prisons are thought to be lower than rates of HCV with one prevalence study in English prisons finding 8 per cent testing positive for anti-HBc (Weild et al , 2000).…”

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

“…Estimates of IDUs engaging in injecting in prison range from 11 [3] to 53% [4]. Evidence of intraprison HCV transmission comes from case reports linked to IDU [5], tattooing [6], bloody fights [7], reuse of barber's shears [8] and sexual transmission via anal sex [9]. HCV seroincidence studies have focused on general prisoners resulting in very low rates of transmission; 0.4 to 1.1 per 100 person years [10,11] and even zero HCV transmission [12].…”