Abstract
OBJECTIVE To estimate the prevalence of hepatitis C virus infection in Brazil’s inmate population.METHODS Systematic review on hepatitis C virus infection in the inmate population. Brazilian studies published from January 1, 1989 to February 20, 2014 were evaluated. The methodological quality of the studies was assessed using a scale of 0 to 8 points.RESULTS Eleven eligible studies were analyzed and provided data on hepatitis C virus infection among 4,375 inmates from seven states of Brazil, with a mean quality classification of 7.4. The overall hepatitis C virus prevalence among Brazilian inmates was 13.6% (ranging from 1.0% to 41.0%, depending on the study). The chances of inmates being seropositive for hepatitis C virus in the states of Minas Gerais (MG), Sergipe (SE), Mato Grosso do Sul (MS), Rio Grande do Sul (RS), Goiás (GO) and Espirito Santo (ES) were 84.0% (95%CI 0.06;0.45), 92.0% (95%CI 0.04;0.13), 88.0% (95%CI 0.09;0.18), 74.0% (95%CI 0.16;0.42), 84.0% (95%CI 0.08;0.31) and 89.0% (95%CI 0.01;0.05) respectively, lower than that observed in the Sao Paulo state (seroprevalence of 29.3%). The four studies conducted in the city of Sao Paulo revealed a lower prevalence in more recent studies compared to older ones.CONCLUSIONS The highest prevalence of hepatitis C virus infection in Brazil’s inmate population was found in Sao Paulo, which may reflect the urban diversity of the country. Despite Brazilian studies having good methodological quality to evaluate the prevalence of the hepatitis C virus, they are scarce and lack data on risk factors associated with this infection, which could support decisions on prevention and implementation of public health policies for Brazilian prisons.
Highlights
Hepatitis C virus (HCV) infection is a major worldwide health care problem
The World Health Organization estimates that approximately 150 million people are chronically infected with HCV, and more than 350,000 people die every year from hepatitis C-related liver diseases.a The disease severity ranges from a mild illness lasting a few weeks to a serious lifelong condition in almost 85.0% of cases, which can lead to liver cirrhosis or liver cancer
11 studies were included in the present review, and their mean quality classification was 7.4 (Table 2)
Summary
Hepatitis C virus (HCV) infection is a major worldwide health care problem. The World Health Organization estimates that approximately 150 million people are chronically infected with HCV, and more than 350,000 people die every year from hepatitis C-related liver diseases.a The disease severity ranges from a mild illness lasting a few weeks to a serious lifelong condition in almost 85.0% of cases, which can lead to liver cirrhosis or liver cancer. People confined in prisons are more likely to engage in high-risk behaviors for HCV infection than the general population,[38] and the serving time in prison increases risk exposures to other prisoners, because they usually have poor access to health care and live in poverty. This exposure may include high-risk sexual practices, such as sexual intercourse with prisoners with a history of sexually transmitted diseases (STD) or with a former or current injection drug user.[38,45] incarceration conditions and the high cost of conducting research hamper a prospective evaluation of the extent of HCV spread within prisons. In Brazil, Gois et al[15] have argued that prisoner health has become a public health problem
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