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. 2018 Mar;62(3S):S18-S26.
doi: 10.1016/j.jadohealth.2017.09.030.

Age-Specific Global Prevalence of Hepatitis B, Hepatitis C, HIV, and Tuberculosis Among Incarcerated People: A Systematic Review

Stuart A Kinner  1 , Kathryn Snow  2 , Andrea L Wirtz  3 , Frederick L Altice  4 , Chris Beyrer  3 , Kate Dolan  5
Affiliations

Age-Specific Global Prevalence of Hepatitis B, Hepatitis C, HIV, and Tuberculosis Among Incarcerated People: A Systematic Review

Stuart A Kinner et al. J Adolesc Health. 2018 Mar.

Abstract

Purpose: This study aims to compare the global prevalence of hepatitis B, hepatitis C, HIV, and tuberculosis in incarcerated adolescents and young adults (AYAs) and older prisoners.

Methods: This study is a systematic review and meta-analysis of studies reporting the age-specific prevalence of each infection in prisoners. We grouped age-specific prevalence estimates into three overlapping age categories: AYA prisoners (<25 years), older prisoners (≥25 years), and mixed category (spanning age 25 years). We used random effects meta-analysis to estimate the relative risk (RR) of each infection in AYAs versus older prisoners.

Results: Among 72 studies, there was marked heterogeneity in prevalence estimates among AYA prisoners for all infections: hepatitis B (.4%-25.2%), hepatitis C (.0%-70.6%), HIV (.0%-15.8%), and active tuberculosis (.0%-3.7%). The pooled prevalence of HIV (RR = .39, 95% confidence interval .29-.53, I2 = 79.2%) and hepatitis C (RR = .51, 95% confidence interval .33-.78, I2 = 97.8%) was lower in AYAs than in older prisoners.

Conclusions: The prevalence of HIV and hepatitis C is lower in AYA prisoners than in older prisoners. Despite lower prevalence, acquisition begins early among incarcerated populations. There is an urgent need for targeted, age-appropriate prevention, treatment, and harm reduction measures in and beyond custodial settings to reduce the incidence of infection in these extremely vulnerable young people.

Keywords: Adolescent; HIV; Hepatitis B; Hepatitis C; Injecting drug use; Meta-analysis; Prisoners; Tuberculosis; Young adult.

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Conflict of interest statement

The study sponsors had no role in study design; collection, analysis, and interpretation of data; writing of the report; or the decision to submit the manuscript for publication. S.A.K. and K.S. co-authored the first draft of the manuscript. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.

Figures

Figure 1
Figure 1
HBV in young versus older prisoners (mixed group excluded).
Figure 2
Figure 2
HCV in young versus older prisoners (mixed group excluded).
Figure 3
Figure 3
HIV in young versus older prisoners (mixed group excluded).
Figure 4
Figure 4
TB in young versus older prisoners (mixed group excluded).
See this image and copyright information in PMC

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