Prevalence and features of chronic viral hepatitis and HIV coinfection in Italian prisons

The most prevalent communicable diseases among prisoners are hepatitis C virus (HCV), hepatitis B virus (HBV) and HIV. The aims of this study were to evaluate the prevalence and features of chronic viral hepatitis and HIV coinfection in Italian prisons, to identify the risk of exposure and to support policy decisions about prevention and treatment programmes that can be adopted. The authors designed a specific clinical record using the programming language Python. The software included the anonymous data obtained through the conversion of prisoners’ personal details into an alphanumeric code. The study considered HBV, HCV, HIV and other diagnoses of infections, according to the International Classification of Diseases, Ninth Revision, Clinical Modification. Out of 17 086 subjects, 15 751 were enrolled in the study (M = 14 835; F = 869), corresponding to 92.2% of the total (mean age of 39.6 years; 94.2% were males). We found that the most frequent infectious diseases were HCV, HBV and HIV (7%, 2% and 2% respectively). The prevalence of HIV/viral hepatitis coinfection was relatively high (1%). Age, previous imprisonment and drug addiction were positively associated with HCV, HBV and HIV infections. In conclusion, prison is one of the main reservoirs of infections, because the prevalence of HCV and HBV infections is higher than in the general population. Frequency of imprisonment, age greater than 31 years and drug addiction were associated with HCV, HBV and HIV coinfection. Screening measures, counselling programmes and treatment protocols should be made mandatory in order to improve health outcomes and prevent further disease.