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Hepatitis B in prisons
Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|January 1, 1986
Summary
Hepatitis B infection rates in prisoners are lower than expected. Targeted vaccination for high-risk groups like IV drug users and female inmates is recommended, alongside segregation of chronic carriers.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Hepatitis B virus (HBV) infection is a significant concern in correctional facilities.
- Previous assumptions suggested a high risk of HBV transmission among incarcerated populations.
Purpose of the Study:
- To evaluate the actual prevalence and incidence of hepatitis B infection markers in prisoners.
- To compare HBV attack rates in prisoners versus the general population.
- To identify high-risk groups within the prison population for targeted interventions.
Main Methods:
- Review of global prevalence studies on hepatitis B markers in prisoners.
- Analysis of seroconversion data to determine HBV incidence rates in male inmates.
- Comparison of observed incidence with predicted attack rates for non-incarcerated populations.
Main Results:
- Hepatitis B marker prevalence in prisoners ranges from 28% to 51%.
- The annual incidence of seroconversion in male prisoners is 0.8% to 1.4%.
- Observed HBV attack rates are substantially lower than the predicted 5% to 10% in similar non-incarcerated groups.
Conclusions:
- Universal hepatitis B vaccination in prisons is not cost-effective due to lower-than-expected incidence.
- Intravenous (IV) drug abusers and female prisoners represent high-risk subgroups warranting immediate immunization.
- Segregation of chronic hepatitis B surface antigen (HBsAg)-positive prisoners, particularly those who are "e" antigen positive or delta antibody positive, is advised.