High prevalence of hepatitis C infection in a brazilian prision: identification of risk factors for infection

RESUMO

Hepatitis C virus (HCV) causes infectious hepatitis worldwide. It is transmitted mainly by blood products and sharing of intravenous paraphernalia during illicit drug use. High prevalence rates have been described among specific groups considered to be at higher risk for HCV infection, including prision inmates. The objectives of this study were to determine the HCV Seroprevalence among inmates of Casa de Detençäo de Säo Paulo; identify risk factors for HCV infection; and to compare the seroprevalence of HCV to other blood borne or sexulally transmitted diseases. From December, 1993, to January, 1994, a total de 779 inmates were interviewed to collect information on sociodemographic status, sexual behavior, and past experience with illict drugs. Blood samples were obtained from 756 inmates for serological tests. 310 (41 percent) blood samples were positive for anti-HCV, 425 (56.2 percent) were negative, and 21 (2.8 percent) showed indeterminate results. In this population, we found a seroprevalence of 13.7 percent for HIV, 3.3 percent for syphylis (VDRL), and 68.1 percent for hepatitis B virus previous infection. Four variables were each identified as associated with a positive anti-HCV serologic test a positive VDRL (OR = 2.631 IC 95 percent 1.08 to 6.36); a time of current imprisonment longer than 130 months (OR = 2.44 IC 95 percent 1.04 to 5.71); previous incarceration at Casa de Detençäo de Säo Paulo (OR = 1.73 IC 95 percent 1.19 to 2.52) and; illict drug use before admission to the Casa de Detençäo de Säo Paulo (OR = 1.64 IC 95 percent 1.15 to 2.33). The seroprevalence of HCV antibodies among the study populations was high (41 percent), indeed, one of the highest clusters of HCV infection recorded until now. Four variables were each shown to be associated with HCV infection. The simultaneous presence of these 4 analysis indicates most HCV infections occur prior to inprisonment, initiation of control measures to prevent continued transmission after incarceration should be done.