School of Medical Sciences, The University of New South Wales, Sydney, New South Wales, Australia.
BMC Public Health. 2010 Oct 22;10:633. doi: 10.1186/1471-2458-10-633.
Hepatitis C virus (HCV) infection is common in prisoner populations, particularly those with a history of injecting drug use (IDU). Previous studies of HCV incidence have been based on small case numbers and have not distinguished risk events in prison from those in the community.
HCV incidence was examined in a longitudinal cohort of 488 Australian prisoners with a history of IDU and documented to be seronegative within 12 months prior to enrollment. Inmates were tested for anti-HCV antibodies and viremia, and interviewed about demographic and behavioral risk factors for transmission.
The cohort was predominantly male (65%) with high rates of prior imprisonment (72%) and tattooing (73%), as well as longstanding IDU (mean 8.5 years). Ninety-four incident HCV cases were identified (incidence 31.6 per 100 person years). Independent associations were observed between incident infection and prior imprisonment (p = 0.02) and tattooing (p = 0.03), and surprisingly also with methadone maintenance treatment (MMT) (p < 0.001).
High rates of new HCV infection were found in this prisoner cohort reflecting their substantive risk behavior profile, despite having remained uninfected for many years. The association with MMT is challenging and highlights the need for better understanding of prison-specific HCV transmission risks, as well as the uptake and effectiveness of prevention programs.
丙型肝炎病毒（HCV）感染在囚犯群体中很常见，尤其是那些有注射吸毒史（IDU）的囚犯。之前关于 HCV 发病率的研究都是基于小样本数量，且没有区分监狱内和社区内的风险事件。
对 488 名有 IDU 史且在入组前 12 个月内血清学检测为阴性的澳大利亚囚犯进行了一项 HCV 发病率的纵向队列研究。对囚犯进行抗 HCV 抗体和病毒血症检测，并对传播的人口统计学和行为风险因素进行访谈。
该队列主要为男性（65%），既往监禁率（72%）和纹身率（73%）较高，且长期有 IDU 史（平均 8.5 年）。共发现 94 例 HCV 感染新发病例（发病率为 31.6/100 人年）。独立相关性分析显示，新发感染与既往监禁（p = 0.02）和纹身（p = 0.03）有关，令人惊讶的是，与美沙酮维持治疗（MMT）也有关（p < 0.001）。
尽管囚犯们多年来一直保持未感染状态，但在这个囚犯队列中发现了高比例的新 HCV 感染，这反映了他们的高风险行为模式。与 MMT 的关联是一个挑战，这凸显了需要更好地了解监狱内 HCV 传播风险，以及提高预防项目的参与度和有效性。
