In 2010 only 30.9%, of the Puy-de-Dome prison detainees were
screened for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and
hepatitis B virus (HBV). Our goal was then to promote these assesments, as well
as to identify addictive behaviour using FAGERSTROM, Cannabis Abuse Screening
Test and CAGE tests, diagnose fibrosis by means of Fibrometer or Fibroscan in
hepatic virus carriers and heavy drinkers, and perform HBV vaccinations.
This prospective study of adult detainees in the prisons of
Puy-de-Dome, France, took place from June 2012 to December 2013.
Of the 702 incarcerated individuals, 396 (56.4%) were
screened and 357 (50.9%) enrolled. HIV prevalence was 0.3%, HCV 4.7% and HBV
0.6%. While 234/294 (79.6%) smokers and 115/145 (79.3%) cannabis users were
screened for dependence, excessive alcohol consumption was tested for in
91/179 (50.8%) cases. Fibrosis was screened for in 75/80 (93.7%) individuals selected
with 16.0% presenting with moderate to severe fibrosis, 4/9 (44.4%) HCV carriers
and 8/65 (12.3%) excessive alcohol consumers. HBV vaccination was given to
81/149 (54.4%) individuals with no serological markers. A total of nine HIV
tests were conducted at the 57 discharge consultations, involving 215 detainees
being released, all of which were negative.
The promotion of these evaluations proved beneficial,
although viral screening could be achieved for only approaching half of the
detainees, as could alcohol consumption assessment and HBV vaccination for
those concerned. Fibrosis screening revealed lesions in HCV carriers yet also
in heavy drinkers, who are typically less likely to be assessed. Consultations
and HIV screening on release were found to be rarely possible.
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By:
- 1 Infectious Diseases Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France cjacomet@chu-clermontferrand.fr.
- 2 Clermont Ferrand and Riom Prisons Medical Units, Emergency Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
- 3 Hepatology Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
- 4 Virology Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
- 5 Emile Roux Centre, CDAG (Free anonymous screening centre), Clermont Ferrand F-63000, France.
- 6 Infectious Diseases Department, Clermont-Ferrand University Hospital, Clermont Ferrand F-63000, France.
- 7 Psychiatric Department, Sainte Marie Hospital, Clermont Ferrand F-63000, France.
- 8 Clermont-Ferrand University Hospital, Biostatistic Unit (DRCI Clinical research and innovation service), Clermont Ferrand F-63000, France.
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