Hepatitis C and B testing in English prisons is low but increasing

Abstract

Background: Prisons are important settings for blood-borne virus control because of the high prevalence of hepatitis C and B viral infections (HCV and HBV), and behaviours associated with transmission among prisoners.

Methods: Data from sentinel laboratories in England were used to identify testing for hepatitis C (anti-HCV) and hepatitis B [hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antigen (HBc)] among male and female prisoners between 2005 and 2008.

Results: Between 2005 and 2008, 10 723 prisoners from 39 prisons in England were tested for anti-HCV, anti-HBc and/or HBsAg. Overall, 24.2% prisoners tested positive for anti-HCV. Anti-HCV testing increased 47% over 4 years (P < 0.001), whilst the proportion testing positive decreased significantly from 26% in 2005 to 23% in 2008 (χ(2)= 10.0, df = 3, P = 0.030). In total, 13.9% people tested positive for anti-HBc. Of 5151 people tested for anti-HBc, 4433 were also tested for HBsAg; of these 2.4% were HBsAg positive. HBsAg testing increased 35% between 2005 and 2008, with no significant change in the proportion testing positive. Between 2005 and 2008, 2.4% (CI: 2.32-2.43%) of the prison population (24 prisons) were estimated to have been tested for anti-HCV.

Conclusions: Although hepatitis testing has increased, only a small proportion of the prison population were tested. More testing is required to identify infected prisoners and refer them for appropriate treatment.