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.

研究背景：目前关于巴西女性囚犯中乙型肝炎病毒（HBV）与丙型肝炎病毒（HCV）感染的相关研究资料较为匮乏。本研究针对巴西中部戈亚斯州的女性囚犯，调查了HBV与HCV感染的流行率及相关危险因素，并完成了病毒基因型鉴定。研究方法：招募戈亚斯州规模最大监狱内的女性囚犯参与本研究。对所有女性囚犯进行访谈，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（anti-HBs）、抗乙型肝炎核心抗原抗体（anti-HBc）以及抗HCV抗体（anti-HCV）。对HBsAg阳性样本与anti-HCV阳性样本分别开展HBV DNA与HCV RNA检测，并进行基因分型。研究结果：共有148名受试者完成研究（占比98.6%），整体HBV感染流行率为18.9%。年龄＞30岁、低文化程度、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感染存在显著关联。仅24%的女性抗-HBs呈阳性，提示曾接种过乙型肝炎疫苗。共有9名女性囚犯（占比6.1%）anti-HCV呈阳性。年龄＞40岁、注射吸毒史以及监禁时长与抗-HCV抗体阳性存在统计学相关性。5份样本HCV RNA呈阳性，经分型为基因型1（亚型1a，n=3；亚型1b，n=1）与基因型3（亚型3a，n=1）。1份HBsAg反应阳性样本的HBV DNA呈阳性，基因型为A型。研究结论：本研究结果凸显了制定公共政策以控制监狱内乙型、丙型肝炎感染的必要性，并强调了在监狱环境中推广乙型肝炎疫苗接种的重要性。