Marco Andrés, Gallego Carlos, Caylà Joan A
Health Services of Barcelona Men's Penitentiary Centre, Barcelona, Department of Justice, Government of Catalonia, Barcelona, Spain.
Health Services of Quatre Camins Penitentiary Centre, La Roca del Vallés, Barcelona, Department of Justice, Government of Catalonia, Barcelona, Spain.
PLoS One. 2014 Feb 28;9(2):e90560. doi: 10.1371/journal.pone.0090560. eCollection 2014.
To estimate the incidence of Hepatitis C virus (HCV) and the predictive factors through repeated routine laboratory analyses.
An observational cohort study was carried out in Quatre Camins Prison, Barcelona. The study included subjects with an initial negative HCV result and routine laboratory analyses containing HCV serology from 1992 to 2011. The incidence of infection was calculated for the study population and for sub-groups by 100 person-years of follow-up (100 py). The predictive factors were determined through Kaplan-Meier curves and a Cox regression. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated.
A total of 2,377 prisoners were included with a median follow-up time of 1,540.9 days per patient. Among the total population, 117 HCV seroconversions were detected (incidence of 1.17/100 py). The incidence was higher between 1992 and 1995 (2.57/100 py), among cases with HIV co-infection (8.34/100 py) and among intravenous drug users (IDU) without methadone treatment (MT) during follow-up (6.66/100 py). The incidence rate of HCV seroconversion among cases with a history of IDU and current MT was 1.35/100 py, which is close to that of the total study population. The following variables had a positive predictive value for HCV infection: IDU (p<0.001; HR = 7,30; CI: 4.83-11.04), Spanish ethnicity (p = 0.009; HR = 2,03; CI: 1.93-3.44) and HIV infection (p = 0.015; HR = 1.97; CI: 1.14-3.39).
The incidence of HCV infection among prisoners was higher during the first part of the study and among IDU during the entire study period. Preventative programs should be directed toward this sub-group of the prison population.
通过重复的常规实验室分析评估丙型肝炎病毒（HCV）的发病率及预测因素。
在巴塞罗那的夸特卡明斯监狱开展了一项观察性队列研究。该研究纳入了HCV初筛结果为阴性且在1992年至2011年期间进行过包含HCV血清学检测的常规实验室分析的受试者。通过每100人年随访（100 py）计算研究人群及亚组的感染发病率。通过Kaplan-Meier曲线和Cox回归确定预测因素。计算风险比（HR）和95%置信区间（CI）。
共纳入2377名囚犯，每位患者的中位随访时间为1540.9天。在总人口中，检测到117例HCV血清学转换（发病率为1.17/100 py）。1992年至1995年期间发病率较高（2.57/100 py），在合并感染HIV的病例中（8.34/100 py）以及在随访期间未接受美沙酮治疗（MT）的静脉吸毒者（IDU）中（6.66/100 py）发病率较高。有IDU病史且目前接受MT治疗的病例中HCV血清学转换的发病率为1.35/100 py，与整个研究人群的发病率相近。以下变量对HCV感染具有阳性预测价值：IDU（p<0.001；HR = 7.30；CI：4.83 - 11.04）、西班牙裔（p = 0.009；HR = 2.03；CI：1.93 - 3.44）和HIV感染（p = 0.015；HR = 1.97；CI：1.14 - 3.39）。
在研究的第一阶段囚犯中HCV感染发病率较高，在整个研究期间IDU中发病率较高。预防项目应针对监狱人群中的这一亚组。
