Seroprevalence and factors associated with hepatitis B virus exposure in the incarcerated population from southern Brazil

Abstract

Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9–12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32–9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58–9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03–2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12–2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48–4.64). The findings indicate that public policies–including vaccination, early diagnosis, harm reduction strategies, and adequate treatment–should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.