Hepatitis C transmission and HIV post-exposure prophylaxis after needle- and syringe-sharing in Australian prisons

Belinda G. O'Sullivan, Michael H. Levy, Kate A. Dolan, Jeffrey J. Post, Sharon G. Barton, Dominic E. Dwyer, John M. Kaldor, Andrew E. Grulich*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

33 Citations (Scopus)

Abstract

Objectives: To determine whether infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) occurred after two potential episodes of exposure through needle- and syringe-sharing in Australian prisons, and to examine use of post-exposure prophylaxis (PEP) against HIV infection in the prison setting. Design: Cohort study of potential contacts of two prisoners infected with HIV, HBV and HCV followed up for up to 14 months. Setting: Two Australian prisons between November 2000 (time of exposure) and December 2001. Participants: Two index patients (both infected with HIV and HCV; one also infectious for HBV) from two different prisons, and 104 inmates who shared needles and syringes. Main outcome measures: Seroconversions to HIV, HBV and HCV related to the high-risk exposure and uptake and completion of HIV PEP determined from medical records of inmates. Results: There were four seroconversions to HCV within 14 months of the potential exposure (14% of those susceptible in the cohort), but no recorded HIV or HBV seroconversions. Forty-six inmates (82% of those eligible) were offered PEP, and 34 of these (74%) elected to receive it. Only eight (24% of the 34) completed the full PEP course. Conclusions: HCV transmission in the prison setting is related to high-risk needle- and syringe-sharing. Administering HIV PEP in the prison setting is complicated by challenging risk assessment and follow-up.

Original languageEnglish
Pages (from-to)546-549
Number of pages4
JournalMedical Journal of Australia
Volume178
Issue number11
Publication statusPublished - 2 Jun 2003
Externally publishedYes

Cite this

O'Sullivan, B. G., Levy, M. H., Dolan, K. A., Post, J. J., Barton, S. G., Dwyer, D. E., ... Grulich, A. E. (2003). Hepatitis C transmission and HIV post-exposure prophylaxis after needle- and syringe-sharing in Australian prisons. Medical Journal of Australia, 178(11), 546-549.
O'Sullivan, Belinda G. ; Levy, Michael H. ; Dolan, Kate A. ; Post, Jeffrey J. ; Barton, Sharon G. ; Dwyer, Dominic E. ; Kaldor, John M. ; Grulich, Andrew E. / Hepatitis C transmission and HIV post-exposure prophylaxis after needle- and syringe-sharing in Australian prisons. In: Medical Journal of Australia. 2003 ; Vol. 178, No. 11. pp. 546-549.
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abstract = "Objectives: To determine whether infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) occurred after two potential episodes of exposure through needle- and syringe-sharing in Australian prisons, and to examine use of post-exposure prophylaxis (PEP) against HIV infection in the prison setting. Design: Cohort study of potential contacts of two prisoners infected with HIV, HBV and HCV followed up for up to 14 months. Setting: Two Australian prisons between November 2000 (time of exposure) and December 2001. Participants: Two index patients (both infected with HIV and HCV; one also infectious for HBV) from two different prisons, and 104 inmates who shared needles and syringes. Main outcome measures: Seroconversions to HIV, HBV and HCV related to the high-risk exposure and uptake and completion of HIV PEP determined from medical records of inmates. Results: There were four seroconversions to HCV within 14 months of the potential exposure (14{\%} of those susceptible in the cohort), but no recorded HIV or HBV seroconversions. Forty-six inmates (82{\%} of those eligible) were offered PEP, and 34 of these (74{\%}) elected to receive it. Only eight (24{\%} of the 34) completed the full PEP course. Conclusions: HCV transmission in the prison setting is related to high-risk needle- and syringe-sharing. Administering HIV PEP in the prison setting is complicated by challenging risk assessment and follow-up.",
author = "O'Sullivan, {Belinda G.} and Levy, {Michael H.} and Dolan, {Kate A.} and Post, {Jeffrey J.} and Barton, {Sharon G.} and Dwyer, {Dominic E.} and Kaldor, {John M.} and Grulich, {Andrew E.}",
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O'Sullivan, BG, Levy, MH, Dolan, KA, Post, JJ, Barton, SG, Dwyer, DE, Kaldor, JM & Grulich, AE 2003, 'Hepatitis C transmission and HIV post-exposure prophylaxis after needle- and syringe-sharing in Australian prisons', Medical Journal of Australia, vol. 178, no. 11, pp. 546-549.

Hepatitis C transmission and HIV post-exposure prophylaxis after needle- and syringe-sharing in Australian prisons. / O'Sullivan, Belinda G.; Levy, Michael H.; Dolan, Kate A.; Post, Jeffrey J.; Barton, Sharon G.; Dwyer, Dominic E.; Kaldor, John M.; Grulich, Andrew E.

In: Medical Journal of Australia, Vol. 178, No. 11, 02.06.2003, p. 546-549.

Research output: Contribution to journalArticleResearchpeer-review

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AU - O'Sullivan, Belinda G.

AU - Levy, Michael H.

AU - Dolan, Kate A.

AU - Post, Jeffrey J.

AU - Barton, Sharon G.

AU - Dwyer, Dominic E.

AU - Kaldor, John M.

AU - Grulich, Andrew E.

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N2 - Objectives: To determine whether infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) occurred after two potential episodes of exposure through needle- and syringe-sharing in Australian prisons, and to examine use of post-exposure prophylaxis (PEP) against HIV infection in the prison setting. Design: Cohort study of potential contacts of two prisoners infected with HIV, HBV and HCV followed up for up to 14 months. Setting: Two Australian prisons between November 2000 (time of exposure) and December 2001. Participants: Two index patients (both infected with HIV and HCV; one also infectious for HBV) from two different prisons, and 104 inmates who shared needles and syringes. Main outcome measures: Seroconversions to HIV, HBV and HCV related to the high-risk exposure and uptake and completion of HIV PEP determined from medical records of inmates. Results: There were four seroconversions to HCV within 14 months of the potential exposure (14% of those susceptible in the cohort), but no recorded HIV or HBV seroconversions. Forty-six inmates (82% of those eligible) were offered PEP, and 34 of these (74%) elected to receive it. Only eight (24% of the 34) completed the full PEP course. Conclusions: HCV transmission in the prison setting is related to high-risk needle- and syringe-sharing. Administering HIV PEP in the prison setting is complicated by challenging risk assessment and follow-up.

AB - Objectives: To determine whether infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) occurred after two potential episodes of exposure through needle- and syringe-sharing in Australian prisons, and to examine use of post-exposure prophylaxis (PEP) against HIV infection in the prison setting. Design: Cohort study of potential contacts of two prisoners infected with HIV, HBV and HCV followed up for up to 14 months. Setting: Two Australian prisons between November 2000 (time of exposure) and December 2001. Participants: Two index patients (both infected with HIV and HCV; one also infectious for HBV) from two different prisons, and 104 inmates who shared needles and syringes. Main outcome measures: Seroconversions to HIV, HBV and HCV related to the high-risk exposure and uptake and completion of HIV PEP determined from medical records of inmates. Results: There were four seroconversions to HCV within 14 months of the potential exposure (14% of those susceptible in the cohort), but no recorded HIV or HBV seroconversions. Forty-six inmates (82% of those eligible) were offered PEP, and 34 of these (74%) elected to receive it. Only eight (24% of the 34) completed the full PEP course. Conclusions: HCV transmission in the prison setting is related to high-risk needle- and syringe-sharing. Administering HIV PEP in the prison setting is complicated by challenging risk assessment and follow-up.

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