No HIV infections despite high numbers of hepatitis B and C virus infections in Dutch prisoners

Abstract

International studies show high prevalences of blood-borne infections in prisoners but little is known about infectious 
diseases in Dutch prisoners. This study assessed the prevalence of HIV, hepatitis B and hepatitis C virus infections in 
Dutch prisoners and contributing risk factors. A cross-sectional serosurvey was conducted among male prisoners, 
using blood samples and questionnaires. Overall, 229 prisoners participated (77%). No prisoner was HIV seropositive. 
Nineteen prisoners (8.3%) were anti-hepatitis B core (anti-HBc) positive, three of whom were hepatitis B surface 
antigen (HBsAg) positive. Fifty (22%) were anti-HBs positive, either after vaccination or previous infection. The 
prevalence of antibodies to Hepatitis C virus (HCV) was 7.4%, of whom 4.8% was HCV-RNA positive. Over half of the 
prisoners reported drug use, 36% reported drug use in prison. The predictor for HBV was IDU (P<0.001); the 
predictors for HCV were higher age and injecting drug users (IDU) (P<0.05). Prevalences among injecting drug users 
(IDUs) were significantly higher than among non-IDUs (P<0.001). While we did not identify any HIV infected prisoners, 
the study showed that seroprevalences of Hepatitis B virus (HBV) and HCV infections among Dutch prisoners were up 
to twenty times higher than estimated for the Dutch general population. IDU was the most commonly reported route of 
transmission. Since only a minority of prisoners was immune to HBV, vaccination coverage in prisoners should be 
enhanced.