Prevalence and Risk Factors for Hepatitis B and Hepatitis C Exposure in Iranian Prisoners: A National Study in 2016

Background: People in prisons are at high risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Objectives: This study aimed to evaluate the prevalence of HBV and HCV exposure and associated risk factors in Iranian prisons. Methods: This cross-sectional study was conducted in 2016, among 29 prisons in Iran, blood samples were collected using multistage sampling. HBV and HCV diagnostic tests were conducted using enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate logistic regression were used for the evaluation of factors associated with HBV and HCV exposure. Results: Among 6,481 people in prisons, the prevalence of HCV and HBV antibodies were 8.21% (95% CI: 7.55 - 8.90) and 3.06% (95% CI: 2.65 - 3.50), respectively. Based on multivariate analysis, the most important risks associated for HCV exposure were the history of drug use (AOR 5.75, 95% CI 3.54 - 9.35) followed by the age of 30 years and older (AOR: 5.02, 95% CI: 3.65 - 6.9), the history of tattooing (AOR 2.42, 95% CI 1.96 - 3), the history of imprisonment (AOR 2.23, 95%CI 1.76 - 2.82), being single (AOR 1.91, 95% CI 1.54 - 2.37), low education (AOR 1.81, 95%CI 1.01 - 3.27), and the history of piercing (AOR 1.26, 95% CI 1.04 - 1.52). There was no significant association between HBV prevalence and independent variables (P > 0.05). Conclusions: These findings highlight a high prevalence of HCV infection in Iranian prisons. Efforts are needed to improve HCV screening and interventions, particularly among people with a history of drug use, and linkage to care.