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Journal of Correctional Health Care
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Viral Hepatitis, Risk Behaviors, Aminotransferase Levels, and Screening Options at a County Correctional Center

Thomas Lincoln, MD

Baystate Medical Center and Tufts University School of Medicine, Springfield, Massachusetts, Hampden County Correctional Center, Ludlow, Massachusetts

Robert W. Tuthill, PhD

University of Massachusetts School of Public Health, Amherst, Hampden County Correctional Center, Ludlow, Massachusetts

Stephen L. DePietro, RPh

Massachusetts College of Pharmacy and Health Sciences, Boston

Michael J. Tocco, RPh, MEd

Integrated Care Group, Inc., Stoneham, Massachusetts

Katherine Keough, MS

Massachusetts College of Pharmacy and Health Sciences, Boston

Thomas J. Conklin, MD

Hampden County Correctional Center, Ludlow, Massachusetts, thomas.lincoln{at}bhs.org

The objective of this study was to obtain information to guide prevention, detection, and treatment of viral hepatitis in a county jail population. Hepatitis A, B, and C serology and alanine aminotransferase levels (ALT) were combined with health information for 463 persons tested at intake in 1999. Prevalence of hepatitis A antibodies was 21.6%. Overall hepatitis B seroprevalence was 26.1%, 17.9% for past or present disease. Serological evidence of hepatitis B vaccination was found in 40% of inmates younger than 20 years but in only 3.9% of those 20 years and older. Prevalence of hepatitis C antibody was 20.7%. Of those, 86.5% were unaware of their diagnosis and 58% used alcohol. Multivariate predictors of hepatitis were sharing needles, elevated ALT, and a history of hepatitis. Hepatitis C accounted for the majority of elevated ALT, with alcohol use a distant second. Overall, the need for hepatitis A and B vaccination remains the rule. Various screening models are presented. General use of ALT testing on intake could contribute significantly to diagnosis of hepatitis C and other liver disease and be used in a simple testing algorithm that identifies most persons with hepatitis C while testing the minority.

Key Words: viral hepatitis • hepatitis serology • transaminases • hepatitis vaccine • jail health screening

Journal of Correctional Health Care, Vol. 12, No. 4, 249-261 (2006)
DOI: 10.1177/1078345806295428
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