Champion J K, Taylor A, Hutchinson S, Cameron S, McMenamin J, Mitchell A, Goldberg D
Greater Glasgow Health Board, UK.
Am J Epidemiol. 2004 Mar 1;159(5):514-9. doi: 10.1093/aje/kwh061.
To gauge the incidence of hepatitis C virus (HCV) infection and associated risk factors among inmates during their imprisonment, the authors recruited adult males in a long-stay Scottish prison into a cohort study between April 1999 and October 2000. On two occasions (at 0 and 6 months), saliva was collected for anonymous HCV antibody testing and risk behavior data were obtained through a self-administered questionnaire. The participation rate was 85% at both initial recruitment (612/719) and follow-up (375/441; 171 men were ineligible for follow-up). For inmates who reported never having injected drugs, ever having injected drugs, having injected drugs during follow-up, and having shared needles/syringes during follow-up, HCV incidences per 100 person-years of incarceration risk were 1, 12, 19, and 27, respectively. Ever having injected drugs (relative risk = 13.0, 95% confidence interval: 1.5, 114.3) and having shared needles/syringes during follow-up (relative risk = 9.0, 95% confidence interval: 1.1, 71.7) were significantly associated with HCV seroconversion. The effectiveness of existing interventions, including the provision of bleach tablets for sterilizing injection equipment, was suboptimal. The development of methadone maintenance programs in prisons and the creation of drug courts to keep offending drug injectors out of prison might help to reduce transmission in this setting.
为评估丙型肝炎病毒（HCV）感染在囚犯监禁期间的发生率及相关风险因素，作者于1999年4月至2000年10月在一所长期关押犯人的苏格兰监狱招募成年男性进行队列研究。在两个时间点（0个月和6个月）收集唾液进行HCV抗体匿名检测，并通过自填问卷获取风险行为数据。初始招募时的参与率为85%（612/719），随访时为85%（375/441；171名男性不符合随访条件）。对于报告从未注射过毒品、曾经注射过毒品、随访期间注射过毒品以及随访期间共用过针头/注射器的囚犯，每100人年监禁风险中的HCV发病率分别为1、12、19和27。曾经注射过毒品（相对风险=13.0，95%置信区间：1.5，114.3）和随访期间共用过针头/注射器（相对风险=9.0，95%置信区间：1.1，71.7）与HCV血清转化显著相关。包括提供用于注射设备消毒的漂白片在内的现有干预措施效果欠佳。在监狱中开展美沙酮维持治疗项目以及设立毒品法庭以使有犯罪行为的吸毒者免于入狱，可能有助于减少这种情况下的传播。
