Epidemiology of the viral hepatitis B and C in female prisoners of Metropolitan Regional Prison Complex in the State of Goiás, Central Brazil

INTRODUCTION: Little information regarding hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian female prisoners exists. This study investigated the prevalence and risk factors associated with HBV and HCV infections and identified viral genotypes among female prisoners in Goiás, Central Brazil. METHODS: Women incarcerated in the largest prison in the State of Goiás were invited to participate in the study. All female prisoners were interviewed and tested for the detection of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), against hepatitis B core antigen (anti-HBc), and antibody against HCV (anti-HCV) by ELISA. HBsAg and anti-HCV positive samples were tested for HBV DNA and HCV RNA and genotyped, respectively. RESULTS: Participants (n=148; 98.6%) completed the study with an overall HBV prevalence of 18.9%. Age >30 years, a low education level, sex with a sexually transmitted diseases carrier, and a male sexual partner serving in the same penitentiary were associated with HBV infections. Only 24% of the women were anti-HBs positive suggesting previous HBV vaccination. Nine female prisoners (6.1%) were anti-HCV positive. Age >40 years, injecting drug use and length of incarceration were statistically associated with anti-HCV antibodies. Five samples were HCV RNA positive and classified as genotypes 1 (subtypes 1a; n=3 and 1b; n=1) and 3 (subtype 3a; n=1). The HBsAg-reactive sample was HBV DNA positive and genotype A. CONCLUSIONS: These findings highlight the necessity of public policies to control hepatitis B and C infections and emphasize the importance of hepatitis B vaccination in prison environments.

引言：目前关于巴西女性囚犯感染乙型肝炎病毒（HBV）与丙型肝炎病毒（HCV）的相关研究数据较为匮乏。本研究针对巴西中部戈亚斯州女性囚犯展开，旨在调查HBV与HCV感染的流行率及相关危险因素，并明确病毒基因型分布情况。
方法：本研究招募戈亚斯州最大监狱内的在押女性参与。对所有入组女性囚犯进行访谈，并采用酶联免疫吸附试验（ELISA）检测乙型肝炎表面抗原（HBsAg）、抗HBsAg抗体（抗-HBs）、抗乙型肝炎核心抗原抗体（抗-HBc）以及抗HCV抗体（抗-HCV）。对HBsAg阳性及抗-HCV阳性样本分别进行HBV DNA、HCV RNA检测及基因分型。
结果：本研究共纳入148名参与者，依从率为98.6%，HBV总体流行率为18.9%。分析显示，年龄＞30岁、低教育水平、与性传播疾病感染者发生性行为以及男性性伴侣在同一监狱服刑，均与HBV感染存在相关性。仅24%的女性抗-HBs呈阳性，提示既往曾接种乙型肝炎疫苗。共有9名女性囚犯（占比6.1%）抗-HCV阳性。年龄＞40岁、注射吸毒及监禁时长与抗-HCV抗体阳性存在统计学关联。5份样本HCV RNA呈阳性，基因型分型为1型（亚型1a共3份、亚型1b共1份）及3型（亚型3a共1份）。1份HBsAg反应阳性样本的HBV DNA检测呈阳性，基因型为A型。
结论：本研究结果凸显了制定公共政策以控制乙型、丙型肝炎感染的必要性，并强调了在监狱环境中推行乙型肝炎疫苗接种的重要性。