Epidemiological study of hepatitis B virus among prisoners with active tuberculosis in Central Brazil.

ABSTRACT

BACKGROUND: Due to environmental and social conditions inherent to incarceration, tuberculosis (TB) and hepatitis B virus (HBV) are major diseases among prison inmates. OBJECTIVE: To determine overall and occult HBV infection (OBI) prevalence rates, risk factors and genotype distribution among inmates with active TB. STUDY DESIGN: A cross-sectional study was conducted among 216 inmates with active TB recruited at the largest prisons in Campo Grande, Mato Grosso do Sul, Central Brazil. The participants were interviewed and tested for the presence of serological markers for HBV infection. RESULTS: The overall prevalence of HBV infection (total hepatitis B core antibodies) was 10.2% (95%CI 6.2-14.2). HBV surface antigen (HBsAg) prevalence was 1.4% (3/216). HBV DNA was detected in all three HBsAg-positive samples and in 10.5% (2/19) of the anti-HBc-positive samples (OBI), giving a HBV-TB co-infection prevalence of 2.3% (5/216). A multivariate analysis of risk factors showed that history of sharing cutting instruments, length of incarceration and homosexual sex were associated with HBV infection. CONCLUSION: Our findings indicate that HBV remains an important public health concern among prison inmates and active TB-HBV co-infection needs to be addressed for effective treatment.