Abstract

International studies show high prevalences of blood-borne infections in prisoners but little is known about infectious diseases in Dutch prisoners. This study assessed the prevalence of HIV, hepatitis B and hepatitis C virus infections in Dutch prisoners and contributing risk factors. A cross-sectional serosurvey was conducted among male prisoners, using blood samples and questionnaires. Overall, 229 prisoners participated (77%). No prisoner was HIV seropositive. Nineteen prisoners (8.3%) were anti-hepatitis B core (anti-HBc) positive, three of whom were hepatitis B surface antigen (HBsAg) positive. Fifty (22%) were anti-HBs positive, either after vaccination or previous infection. The prevalence of antibodies to Hepatitis C virus (HCV) was 7.4%, of whom 4.8% was HCV-RNA positive. Over half of the prisoners reported drug use, 36% reported drug use in prison. The predictor for HBV was IDU (p<0.001); the predictors for HCV were higher age and injecting drug users (IDU)(p<0.05). Prevalences among injecting drug users (IDUs) were significantly higher than among non-IDUs (p<0.001). While we did not identify any HIV infected prisoners, the study showed that seroprevalences of Hepatitis B virus (HBV) and HCV infections among Dutch prisoners were up to twenty times higher than estimated for the Dutch general population. IDU was the most commonly reported route of transmission. Since only a minority of prisoners was immune to HBV, vaccination coverage in prisoners should be enhanced.

Key words: Epidemiology, blood-borne infection, hepatitis, HIV infection, injecting drug use, prison, seroprevalence.