Prevalence of Hepatitis C in a German Prison for Young Men in Relation to Country of Birth

A high prevalence of hepatitis C (HCV) virus infection of up to 80% has been reported for injecting drug users (IDUs) in prison communities. However, there are only very limited data available on the prevalence and course of HCV in young offenders. We performed a study on hepatitis C markers in the largest German Young Offenders' Institution (YOI), a prison for men (aged 16-24 years). In 2002, all 1176 incoming offenders were asked to participate in the study of whom >95% agreed. Ninety-seven inmates (8.6%) tested positive for anti-HCV or HCV RNA, 79% of whom were viraemic. None of the patients had evidence of cirrhosis at presentation. Interestingly, six individuals (6%) tested positive for HCV RNA in the absence of anti-HCV antibodies, four of whom cleared HCV spontaneously during follow-up without either clinical signs of acute hepatitis or developing HCV antibodies. Hepatitis C markers were significantly more prevalent among immigrants from the former Soviet Union (NIS) than among German inmates (31% vs. 6% respectively, P<0.0001). HIV co-infection was found in five individuals, all of whom were German. In contrast, hepatitis B surface antigen (HBsAg) was detected in five NIS immigrants, one Lebanese and one German inmate. HCV genotypes 2 and 3 were more prevalent in immigrants than in German inmates, while biochemical parameters did not differ significantly between the two groups. In conclusion, the prevalence of hepatitis C was relatively low among inmates of German YOIs although there were significant differences in relation to the country of birth. Our data highlight the need for educational programmes for young offenders in order to prevent the further spread of HCV.