Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey

Objectives To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in enu-ants to Ir ish prisons and to examine risk factors for infection. Design Cross sectional, anonymous survey, with self completed risk factor questionnaire and oral fluid specimen for antibody testing. Setting Five of seven committal prisons in the Republic of Ireland. Participants 607 of the 718 consecutive prison entrants from 6 April to 1 May 1999. Main outcome measures Prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in prison entrants, and self reported risk factor status. Results Prevalence of antibodies to hepatitis B core antigen was 37/596 (6%; 95% confidence interval 4% to 9%), to hepatitis C virus was 130/596 (22%; 19% to 25%), and to HIV was 12/596 (2%; 1% to 4%). A third of the respondents had never previously been in prison; these had the lowest prevalence of antibodies to hepatitis B core antigen (4/197, 2%), to hepatitis C (6/197, 3%), and to HIV (0/197). In rata 29% of respondents (173/593) reported ever injecting drugs, but only 7% (14/197) of those entering prison for the first tune reported doing so compared with 40% (157/394) of those previously in prison. Use of injected drugs was the most important predictor of antibodies to hepatitis B core antigen acid hepatitis C virus. Conclusions Use of injected drugs and infection with hepatitis C virus are endemic in Irish prisons. A third of prison enu-ants were committed to prison for the first time. Oily a small number of first time entrants were affected with one or more of die viruses. These findings confirm the need for increased infection control and harm reduction measures in Irish prisons.