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Clinical Trial
. 2021 Jul 27;21(1):708.
doi: 10.1186/s12879-021-06405-z.

A multicentre interventional study to assess blood-borne viral infections in Belgian prisons

Dana Busschots  1   2 , Cécile Kremer  3 , Rob Bielen  4   5 , Özgür M Koc  4   5   6 , Leen Heyens  4   5   6 , Christian Brixko  7   8 , Pierre Laukens  8 , Hans Orlent  8   9   10 , Pascal Bilaey  8 , Francis De Smet  8 , Geert Hellemans  8 , Gaetan Muyldermans  11 , Luk Van Baelen  11 , Niel Hens  3   12 , Hans Van Vlierberghe  10 , Geert Robaeys  4   5   13
Affiliations
Clinical Trial

A multicentre interventional study to assess blood-borne viral infections in Belgian prisons

Dana Busschots et al. BMC Infect Dis. .

Abstract

Background: Prevalence data on viral hepatitis B (HBV), hepatitis C (HCV), and HIV infection in prison are often scarce or outdated. There is currently no systematic screening for these blood-borne viral infections (BBV) in Belgian prisons. There is an urgency to assess the prevalence of these BBV to inform policymakers and public healthcare.

Methods: This was a multicentre, interventional study to assess the prevalence of BBV using opt-in screening in prisons across Belgium, April 2019 - March 2020. Prisoners were tested using a finger prick and BBV risk factors were assessed using a questionnaire. A generalized linear mixed model was used to investigate the association between the various risk factors and HCV.

Results: In total, 886 prisoners from 11 Belgian prisons were screened. Study uptake ranged from 16.9 to 35.4% in long-term facilities. The prevalence of HCV antibodies (Ab), hepatitis B surface antigen (Ag) and HIV Ab/Ag was 5.0% (44/886), 0.8% (7/886), and 0.2% (2/886). The adjusted odds for HCV Ab were highest in prisoners who ever injected (p < 0.001; AOR 24.6 CI 95% (5.5-215.2). The prevalence of detectable HCV RNA in the total cohort was 2.1% (19/886). Thirteen (68.4%) prisoners were redirected for follow-up of their HCV infection.

Conclusions: Opt-in testing for viral hepatitis B, C and HIV was relatively well-accepted in prisons. Compared with the general population, prisoners have a higher prevalence of infection with BBV, especially for HCV. Systematic screening for these BBV should be recommended in all prisons, preferably using opt-out to optimize screening uptake.

Trial registration: Retrospectively registered at clinical trials NCT04366492 April 29, 2020.

Keywords: Blood borne viral infections; HIV; Hepatitis B; Hepatitis C; Prison; Recommendations; Screening.

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Conflict of interest statement

D.B. has received travel grants from AbbVie and Gilead Sciences and research grants from Gilead; R.B. has received travel grants from AbbVie, Gilead Sciences and Merck Sharp & Dohme (MSD) and research grants from Gilead and MSD; O.K. has received a travel grant from Gilead Sciences and his institution received research grants from Gilead Sciences and CyTuVax BV; C.B. has received travel grants from AbbVie and Gilead Sciences; N.H. has received grants from GlaxoSmithKline (GSK), Johnson & Johnson pharmaceuticals and Pfizer,; H.V.V has not received grants, but the department has received grants from Gilead, Janssen Pharmaceuticals, Roche, Abbvie, Merck, Falk, Ferring, Bayer; G.R. has received research grants from AbbVie, Janssen Pharmaceuticals, MSD, and consultancy agreements for AbbVie, BMS, Gilead Sciences and MSD. All other co-authors report no competing interests.

Figures

Fig. 1
Fig. 1
Cascade of care of hepatitis C in prison. Abbreviations: HCV hepatitis C virus, Ab antibody
See this image and copyright information in PMC

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