Prevalence and risk factors of hepatitis B virus genotype d amongst inmates in alborz province, Iran: A cross-sectional survey

Abstract

Objectives: The aim of the present study was to determine the rate, risk factors and genotypes of Hepatitis B virus amongst imprisoned men as a high-risk subpopulation. Patients and Methods: This study was an anonymous cross-sectional study conducted on 3000 sentenced men in Karaj jails from 1 December 2008 to 28 November 2009. HBV serological markers [hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg)], human immunodeficiency virus antibody (anti-HIV) and hepatitis C antibody (anti-HCV) were analyzed by the ELISA technique. Nested PCR was done for the detection of HBV DNA and patterns of restriction fragment length polymorphisms (RFLP) were obtained to determine the HBV genotypes. These patterns were confirmed by direct sequencing. Results: Hepatitis B surface antigen (HBsAg) was found in 122/3000 (4.1%) prisoners. Hepatitis B e antigen (HBeAg), anti-HIV, anti-HCV and anti-HIV/anti-HCV were detected in 52/122 (42.6%), 12/122 (10%), 22/122 (18%) and 3/122 (2.4%) prisoners, respectively. The HBV-DNA was found in 115/122 (94.3%) prisoners. The most high risk behavior was to utilize the collaborative syringe by injecting drug users (IDUs) with or without other risk factors (75.3%). Genotype D1 was obviously the only predominant type (100%). Conclusions: The rate of HBV in prisoners was significantly higher than that reported for the general population (4.1% vs. < 2%). Blood borne viral co-infections were prevalent in HBsAg positive prisoners. Continual tracing of genotypes and risk factors are helpful for identifying transmission patterns and target at-risk groups for preventive programs. High rates of HBV in prisoners indicates the need for extensive free of charge vaccination of this subpopulation.Hepatitis B is the most serious type of viral hepatitis infection. It can cause chronic liver disease and puts people at a high risk of death from cirrhosis of the liver and liver cancer. Worldwide, about two billion people have been infected with the hepatitis B virus (HBV) and more than 240 million have chronic (long-term) liver infections. About 600,000 people die every year from this serious infection. Unfortunately, high rate of intravenous drug use, high-risk sexual behaviors and overcrowding have increasingly made prisons a breeding ground for hepatitis B infection. © 2013, Ahvaz Jundishapur University of Medical Sciences; Licensee Kowsar Ltd.