Age-Specific Global Prevalence of Hepatitis B, Hepatitis C, HIV, and Tuberculosis Among Incarcerated People: A Systematic Review

作者：Kinner Stuart A; Snow Kathryn; Wirtz Andrea L; Altice Frederick L; Beyrer Chris; Dolan Kate

来源：Journal of Adolescent Health, 2018, 62(3): S18-S26.

DOI：10.1016/j.jadohealth.2017.09.030

• Prisoners
• Injecting drug use
• HIV
• Hepatitis C
• Hepatitis B
• Tuberculosis
• Meta-analysis
• Adolescent
• Young adult

Purpose: This study aims to compare the global prevalence of hepatitis B, hepatitis C, HIV, and tuberculosis in incarcerated adolescents and young adults (AYAs) and older prisoners.
Methods: This study is a systematic review and meta-analysis of studies reporting the agespecific prevalence of each infection in prisoners. We grouped age-specific prevalence estimates into three overlapping age categories: AYA prisoners (<25 years), older prisoners (>= 25 years), and mixed category (spanning age 25 years). We used random effects meta-analysis to estimate the relative risk (RR) of each infection in AYAs versus older prisoners.
Results: Among 72 studies, there was marked heterogeneity in prevalence estimates among AYA prisoners for all infections: hepatitis B (. 4%-25.2%), hepatitis C (.0%-70.6%), HIV (.0%-15.8%), and active tuberculosis (.0%-3.7%). The pooled prevalence of HIV (RR = .39, 95% confidence interval .29-.53, I-2 = 79.2%) and hepatitis C (RR = .51, 95% confidence interval .33-.78, I-2 = 97.8%) was lower in AYAs than in older prisoners.
Conclusions: The prevalence of HIV and hepatitis C is lower in AYA prisoners than in older prisoners. Despite lower prevalence, acquisition begins early among incarcerated populations. There is an urgent need for targeted, age-appropriate prevention, treatment, and harm reduction measures in and beyond custodial settings to reduce the incidence of infection in these extremely vulnerable young people.

• 出版日期2018-3