Abstract
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.
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