Prevalence and incidence of bloodborne viral infections among Danish prisoners

In order to determine the prevalence and incidence of bloodborne viral infe ctions among prisoners, we conducted a prospective study in a Danish medium security prison for males. The prisoners were offered an interview and blo od test for hepatitis and human immunodeficiency virus HIV at inclusion as well as at release from prison or end of study. Of 403 prisoners available 325 (79%) participated in the initial survey and for 142 (44%) a follow-up test was available. 43% (140/325) of the participants were injecting drug u sers (IDUs) of whom 64% were positive for hepatitis B (HBV) and 87% for hep atitis C (HCV) markers. No cases of HIV or human T lymphotropic virus (HTLV ) were found. 32% of all prisoners could transmit HBV and/or HCV by blood c ontact. 70% of IDUs had shared injecting equipment, and 60% had injected in side prison. Only 2% of IDUs were vaccinated against HBV. Duration of injec ting drug use, numbers of imprisonments, and injecting in prison were indep endently and positively associated with the presence of HBV antibodies amon g IDUs by logistic regression analysis. The HBV incidence was 16/100 PY (95 % CI: 2-56/100 PY) and the HCV incidence 25/100 PY (1-140) among injecting drug users (IDUs). We conclude that IDUs in prison have an incidence of hep atitis B and C 100 times higher than reported in the general Danish populat ion. They should be vaccinated against hepatitis B and new initiatives to s top sharing of injecting equipment in and outside prison is urgently needed .