October 10, 2013
SAN FRANCISCO – Prison inmates in Mexico had a high prevalence of hepatitis C infection, with tattoos and drug use, particularly injected drugs, the most prominent observed risk factors in a study presented at ID Week 2013.
In a cross-sectional study of 10 prisons in Guanajuato, researchers administered hepatitis C testing to 3,639 inmates, who also responded to questionnaires assessing behaviors related to HCV infection risk. Among respondents, 4.7% tested positive for HCV, with infected patients more likely than those without HCV to have a higher education level (P=.05) and have previously been incarcerated (10% of cases vs. 2.5%; P<.01).
Tattoos before incarceration were more common among HCV-positive participants (79% vs. 44%; P<.01) who also had more tattoos per person (8.4 compared with 5; P<.001). Patients with HCV were more likely to report alcohol consumption (88.3% vs. 78.3%; P=.01) and frequent drunkenness (2.5 days/week vs. 1.8 days/week; P=.01) before incarceration. Pre-incarceration drug use also was more common among HCV-positive participants (85% vs. 60%; P<.0001); specifically heroin, crack, amphetamines and injection drugs (79% vs. 11%). Reports of shared injection drug use (IDU) materials were more frequent in this population than among noninfected inmates (59% vs. 2%; P=.001).
During their current incarceration, similar results were observed: More HCV-positive patients reported getting tattoos (31% vs. 21%; P=.03) and drug use (53% vs. 31%; P<.001). Multivariate analysis indicated that drug use and tattoos before incarceration were independently associated with HCV infection.
“The prevalence of HCV infection and associated behavioral risk factors are very high in comparison to those of the general population in Mexico,” the researchers concluded. “The single most important risk factor for HCV infection in this inmate population in a country with low prevalence of HCV and IDU is IDU before incarceration. Preventive programs, such as clean tattooing and methadone provision, should be considered as a public health intervention for these inmates.”