Prevalence and Risk Factors for Hepatitis B and Hepatitis C Exposure in Iranian Prisoners: A National Study in 2016

Abstract

Background: People in prisons are at high risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Objectives: This study aimed to evaluate the prevalence of HBV and HCV exposure and associated risk factors in Iranian prisons. Methods: This cross-sectional study was conducted in 2016, among 29 prisons in Iran, blood samples were collected using multi-stage sampling. HBV and HCV diagnostic tests were conducted using enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate logistic regression were used for the evaluation of factors associated with HBV and HCV exposure. Results: Among 6,481 people in prisons, the prevalence of HCV and HBV antibodies were 8.21 (95 CI:7.55-8.90) and 3.06 (95 CI:2.65-3.50), respectively. Based on multivariate analysis, the most important risks associated for HCV exposure were the history of drug use (AOR 5.75, 95 CI 3.54-9.35) followed by the age of 30 years and older (AOR: 5.02, 95 CI: 3.65-6.9), the history of tattooing (AOR 2.42, 95 CI 1.96-3), the history of imprisonment (AOR 2.23, 95 CI 1.76-2.82), being single (AOR 1.91, 95 CI 1.54-2.37), low education (AOR 1.81, 95 CI 1.01-3.27), and the history of piercing (AOR 1.26, 95 CI 1.04-1.52). There was no significant association between HBV prevalence and independent variables (P > 0.05). Conclusions: These findings highlight a high prevalence of HCV infection in Iranian prisons. Efforts are needed to improve HCV screening and interventions, particularly among people with a history of drug use, and linkage to care.