[Seroprevalence of hepatitis C infection and associated factors in addicts imprisoned at Khezrabad prison, Sari]

ABSTRACT

Though incarcerated populations are at a high risk of developing hepatitis C virus [HCV] infection, prisoners are not routinely screened for HCV infection. Approximately, 1 in 4 of the nearly 2 million prisoners in the U.S. is infected with HCV. Injection drug abusers are currently the main risk group. Among intravenous drug abusers over the world, the prevalence of HCV varies from 50-90% with an annual incidence of 10-30%. Prisons are a high risk environment for hepatitis C infection because of high incidence of drug abuse and high risk sexual activities. Serologic evidences show that HCV infection is present in one out of every three prisoners. The purpose of this study was to determine the seroprevalence of Hepatitis C infection and its associated factors among addicted prisoners in Khezrabad prison of Sari. This was a cross - sectional study done in September 2001 at the Khezrabad prison for addicts in Sari. 312 addicts participated in the study and were selected by simple random sampling method. Their blood samples were tested by third generation enzyme immunoassay [EIA-3 sensitivity 100%, specificity 100%] at Sari's blood transfusion center. The data was collected via a questionnaire and interview. 230 prisoners [74%] completed the questionnaires. Associated factors of Hepatitis C infection were compared in 82 anti-HCV positive addicts [the affected group] and 148 anti-HCV negative addicts [the unaffected group]. There were no significant differences about confounding variables between the two groups. Statistical analysis was done by chi[2], t test and multivariate logistic regression analysis. Of the 312 addicted prisoners, 96 [30.8%] were anti-HCV positive. Major associated factors with Hepatitis C infection in the affected group included; duration of addiction [mean 174 months], duration of imprisonment [mean 48 months], methods of drug usage [injection 82% and intranasal 44%], length of alcohol consumption for more than five years [60%], tattooing [66%], shared usage of needles [31%] and razors [53%], multiple sexual partners [>74%] and the type of drugs [especially heroin 90% and hashish. 64%] [p<0.05] On multivariate logistic regression analysis, significant independent risk factors for HCV infection included tattooing [OR 100, 95% CI], multiple sexual partners[OR4.97,95%CI]and history of surgery[OR 6.23,95% CI ] . Hepatitis C infection is highly prevalent in addicted prisoners and high risk and unsafe behaviors are the main factors of contamination