A multicentre interventional study to assess blood-borne viral infections in Belgian prisons.

Dana Busschots, Cécile Kremer, Rob Bielen, Özgür M Koc, Leen Heyens, Christian Brixko, Pierre Laukens, Hans Orlent, Pascal Bilaey, Francis De Smet, Geert Hellemans, Gaetan Muyldermans, Luk Van Baelen, Niel Hens, Hans Van Vlierberghe, Geert Robaeys

Journal: BMC infectious diseases 2021;21(1):708

PMID: 34315415

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Abstract

BACKGROUND

Prevalence data on viral hepatitis B (HBV), hepatitis C (HCV), and HIV infection in prison are often scarce or outdated. There is currently no systematic screening for these blood-borne viral infections (BBV) in Belgian prisons. There is an urgency to assess the prevalence of these BBV to inform policymakers and public healthcare.

METHODS

This was a multicentre, interventional study to assess the prevalence of BBV using opt-in screening in prisons across Belgium, April 2019 - March 2020. Prisoners were tested using a finger prick and BBV risk factors were assessed using a questionnaire. A generalized linear mixed model was used to investigate the association between the various risk factors and HCV.

RESULTS

In total, 886 prisoners from 11 Belgian prisons were screened. Study uptake ranged from 16.9 to 35.4% in long-term facilities. The prevalence of HCV antibodies (Ab), hepatitis B surface antigen (Ag) and HIV Ab/Ag was 5.0% (44/886), 0.8% (7/886), and 0.2% (2/886). The adjusted odds for HCV Ab were highest in prisoners who ever injected (p < 0.001; AOR 24.6 CI 95% (5.5-215.2). The prevalence of detectable HCV RNA in the total cohort was 2.1% (19/886). Thirteen (68.4%) prisoners were redirected for follow-up of their HCV infection.

CONCLUSIONS

Opt-in testing for viral hepatitis B, C and HIV was relatively well-accepted in prisons. Compared with the general population, prisoners have a higher prevalence of infection with BBV, especially for HCV. Systematic screening for these BBV should be recommended in all prisons, preferably using opt-out to optimize screening uptake.

TRIAL REGISTRATION

Retrospectively registered at clinical trials NCT04366492 April 29, 2020.

Address: Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium. [email protected].; Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium. [email protected].; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-Biostat), Data Science Institute, Hasselt University, Diepenbeek, Belgium.; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.; Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.; Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.; School of NUTRIM, Maastricht University Medical Centre, Maastricht, the Netherlands.; Department of Gastroenterology and Hepatology, CHR Citadelle, Liège, Belgium.; Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium.; Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium.; Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium.; Department of Gastroenterology and Hepatology, AZ St-Jan, Bruges, Belgium.; Department of Gastroenterology and Hepatology, UZ Gent, Ghent, Belgium.; Epidemiology and Public Health, Sciensano, Brussels, Belgium.; Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-Biostat), Data Science Institute, Hasselt University, Diepenbeek, Belgium.; Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.; Department of Gastroenterology and Hepatology, UZ Gent, Ghent, Belgium.; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.; Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.; Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium.

DOI: 10.1186/s12879-021-06405-z

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MeSH Terms: Belgium, HIV Infections, HIV-1, Hepatitis B, Hepatitis C, Hepatitis C Antibodies, Humans, Prevalence, Prisoners, Prisons, Risk Factors