Murray Karen F, Richardson Laura P, Morishima Chihiro, Owens James W M, Gretch David R
Hepatobiliary Program, Division of Gastroenterology and Nutrition, Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington 98105-0371, USA.
Pediatrics. 2003 Jan;111(1):153-7. doi: 10.1542/peds.111.1.153.
Hepatitis C virus (HCV) infection is the leading cause of liver failure in adulthood. Although the prevalence of HCV is reportedly as high as 80% in incarcerated adult populations, little is known about the prevalence of HCV in incarcerated juvenile populations. The purpose of this study was to determine the prevalence of HCV and high-risk behaviors in a population of incarcerated youths.
We conducted a cross-sectional prevalence study of HCV infection in youths who were admitted to a juvenile detention center between September 1999 and January 2001. Subjects were asked questions regarding behaviors that might put them at risk for acquiring HCV, and blood was drawn for HCV antibody testing. Qualitative HCV RNA testing was performed on antibody-positive subjects.
Seventy-four percent (n = 305) of youths consented to participate in the seroprevalence study. HCV risk behaviors were common in this population: sexual activity (70%), intravenous drug use (6%), intranasal drug use (32%), body piercing (53%), and tattoos (33%). Six study youths (2%) were HCV antibody positive; 4 of these subjects were also HCV RNA positive. HCV-positive status was significantly associated with history of intravenous drug use and having had a sexually transmitted disease. Only 17% of study participants could correctly identify behaviors that might put them at risk for HCV.
The prevalence of HCV in incarcerated youths is higher than in the general pediatric population but not yet at adult levels of prevalence. Given the high prevalence of risk factors in this population, future studies should address the need for targeted HCV screening and education of incarcerated youths regarding risks for HCV.
丙型肝炎病毒(HCV)感染是成人肝衰竭的主要原因。尽管据报道,在成年在押人群中HCV的患病率高达80%,但对于在押青少年人群中HCV的患病率却知之甚少。本研究的目的是确定在押青少年人群中HCV的患病率及高危行为。
我们对1999年9月至2001年1月期间被收押至青少年拘留中心的青少年进行了HCV感染的横断面患病率研究。询问受试者可能使其有感染HCV风险的行为相关问题,并采集血液进行HCV抗体检测。对抗体阳性受试者进行定性HCV RNA检测。
74%(n = 305)的青少年同意参与血清患病率研究。HCV风险行为在该人群中很常见:性行为(70%)、静脉吸毒(6%)、鼻吸毒品(32%)、身体穿孔(53%)和纹身(33%)。6名研究青少年(2%)HCV抗体呈阳性;其中4名受试者HCV RNA也呈阳性。HCV阳性状态与静脉吸毒史和患有性传播疾病显著相关。只有17%的研究参与者能够正确识别可能使其有感染HCV风险的行为。
在押青少年中HCV的患病率高于普通儿科人群,但尚未达到成人患病率水平。鉴于该人群中危险因素的高患病率,未来的研究应针对在押青少年进行有针对性的HCV筛查以及关于HCV风险的教育需求。