Medical Unit of the Administrative Detention Centre (UMCRA), CHU Nîmes, Univ Montpellier, UMCRA 162 avenue Clément Ader, 30000, Nîmes, France.
Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), CHU Nîmes, Univ Montpellier, Nîmes, France.
J Epidemiol Glob Health. 2024 Sep;14(3):923-932. doi: 10.1007/s44197-024-00238-0. Epub 2024 May 13.
In France, migrants constitute a significant proportion of people diagnosed with HIV, hepatitis C (HCV) and B (HBV). This study estimated the prevalence of these three viruses among detainees at a French administrative detention centre (CRA), through systematic Rapid Diagnostic Test (RDT) screening.
This prospective, single-centre, cross-sectional, pilot study included detainees at the Nîmes CRA from February to December 2022. The primary endpoint was HIV, HCV and HBV prevalence determined by RDT. Secondary outcomes were: co-infections; study acceptability, reasons for non-inclusion, causes of non-contributory samples; and concordance between serological tests and RDT.
Among the 350 people agreeing to participate of 726 eligible, five refused the RDT, leaving 345 analysable participants for a participation rate of 47.5% (345/726). Participants were predominantly male (90%) with an average age of 31 years. The most common country of origin was Algeria (34%). Twenty (6%) had taken drugs intravenously and 240 (70%) had had unprotected sex within a median of 4.92 [1.08; 15] months. Virus prevalence was: 0% HIV; 4.64 [2.42; 6.86] % HCV; and 2.32 [1.01; 4.52] % HBV. Eleven (73%) of the RDT HCV positive cases were confirmed serologically. RDT detected one false-positive HCV case, as an anti-HCV Ac serological test was negative. Of the eight patients with positive HBV RDT, one declined the serology testing, thus 100% (7/7) of the tested RDT positive cases were confirmed by serology.
The study highlighted the need to screen detainees for HIV, HCV and HBV infection and suitability of RDTs.
在法国,移民在感染 HIV、丙型肝炎(HCV)和乙型肝炎(HBV)的人群中占很大比例。本研究通过系统的快速诊断检测(RDT)筛查,估算了法国行政拘留中心(CRA)被拘留者中这三种病毒的流行率。
这是一项前瞻性、单中心、横断面、试点研究,纳入了 2022 年 2 月至 12 月期间在尼姆 CRA 的被拘留者。主要终点是通过 RDT 确定的 HIV、HCV 和 HBV 的流行率。次要结果是:合并感染;研究可接受性、拒绝入组的原因、无样本原因;以及血清学检测和 RDT 的一致性。
在 726 名符合条件的人中,有 350 人同意参与,其中 5 人拒绝接受 RDT,因此有 345 名可分析参与者,参与率为 47.5%(345/726)。参与者主要为男性(90%),平均年龄为 31 岁。最常见的原籍国是阿尔及利亚(34%)。20 人(6%)曾静脉吸毒,240 人(70%)在中位数为 4.92[1.08;15]个月内有过无保护性行为。病毒流行率为:0%HIV;4.64[2.42;6.86]%HCV;2.32[1.01;4.52]%HBV。11 例(73%)RDT HCV 阳性病例经血清学确认。RDT 检测到 1 例 HCV 假阳性病例,而抗 HCV Ac 血清学检测为阴性。在 8 例 RDT 阳性的 HBV 患者中,有 1 例拒绝进行血清学检测,因此 100%(7/7)经 RDT 检测阳性的病例均经血清学确认。
该研究强调了对被拘留者进行 HIV、HCV 和 HBV 感染筛查以及 RDT 适用性的必要性。