Accelerated vaccination against HBV infection is an important strategy for the control of HBV infection in prisons

I read with interest the article by Stief et al. published in your journal recently1. It showed us that hepatitis B virus (HBV) infection remains a significant problem in prisons, and it was related with other published studies2,3. The finding on higher prevalence of HBV infection in the male gender and in prisoners with positive history of intravenous drug use and STD demonstrated a new strategy for the control of HBV infection in prisons. Low vaccination coverage and the high number of injecting drug users (IDUs) suggest that most of them are susceptible to this infection. Prisoners and IDUs are at constant risk of HBV infection, and the classic 6-month HBV vaccination might not provide immunization rapidly enough4,5. Compared with classic HBV vaccination regimen, an accelerated 0, 1, 4, and 8 weeks vaccination schedule can achieve early seroprotection more rapidly, provides clinically sufficient seroprotection with higher compliance in prisoners, and can be suggested in situations that rapid immunization against HBV infection is warranted4. I suggest the selection of higher-risk groups in prisons, including males with history of IDUs and STD, to start the accelerated vaccination against HBV infection early. This will be extremely useful to ensure immunity against HBV infection soon.


Accelerated vaccination against HBV infection is an important strategy for the control of HBV infection in prisons
Vacinação rápida contra a infecção por VHB é uma estratégia importante para o controle da infecção pelo VHB em presídios Seyed Moayed Alavian 1 Dear Editor: I read with interest the article by Stief et al. published in your journal recently 1 .It showed us that hepatitis B virus (HBV) infection remains a significant problem in prisons, and it was related with other published studies 2,3 .The finding on higher prevalence of HBV infection in the male gender and in prisoners with positive history of intravenous drug use and STD demonstrated a new strategy for the control of HBV infection in prisons.Low vaccination coverage and the high number of injecting drug users (IDUs) suggest that most of them are susceptible to this infection.
Prisoners and IDUs are at constant risk of HBV infection, and the classic 6-month HBV vaccination might not provide immunization rapidly enough 4,5 .Compared with classic HBV vaccination regimen, an accelerated 0, 1, 4, and 8 weeks vaccination schedule can achieve early seroprotection more rapidly, provides clinically sufficient seroprotection with higher compliance in prisoners, and can be suggested in situations that rapid immunization against HBV infection is warranted 4 .I suggest the selection of higher-risk groups in prisons, including males with history of IDUs and STD, to start the accelerated vaccination against HBV infection early.This will be extremely useful to ensure immunity against HBV infection soon.
I would like to inform those identified by Stief et al. as having high risk of contracting HBV infection, particularly those in prisons and of old age, that being infected would be related to more duration of staying in high-risk place (prison) and more exposure with the risk factors.And finally, I would like to ask about hepatitis C virus (HCV) and HIV infections, which are more common in IDU groups 6 as stated in the literature; the authors did not present this in their study.
Introduction factors among prison in Campo MS.Methods: A total of 408 individuals were interviewed regarding sociodemographic characteristics, associated factors and HBV vaccination using a standardized questionnaire.Blood samples were collected from all participants and serological markers for HBV were detected by enzyme-linked immunosorbent assay.Hepatitis B surface antigen (HBsAg) and/or antibodies against hepatitis B core antigen (anti-HBc) positive samples were tested for HBV-DNA by polymerase chain reaction.Results: rate was 0.5%; 56 (13.7%) individuals had been infected and developed natural immunity and 15 (3.7%) were positive for anti-HBc only.Ninety eight (24%) prisoners had only anti-HBs, among anti-HBc-positive individuals.Multivariate analysis associated factors showed that HBV infection.Conclusions: of the data showed HBV prevalence similar or slightly lower than that reported in other of Brazilian prisons.Independent predictors of HBV infection in this population include older age, low schooling level and illicit drug use.Key-words: Hepatitis B. Prisoners.Prevalence.Associated factors.
Despite the availability of effective vaccines, hepatitis B virus (HBV) infection remains a very important public health problem.Of the 2 billion people who have been infected with HBV, it is estimated that there are still more than 350 million chronic carriers worldwide 1 .
Brazil is considered a country with intermediate prevalence, within which distinct geographical areas may present high or low incidence 2,3,4 .
Studies have reported that the prevalence of HBV infection is higher in the prison population than in the general population 5,6 .International studies show that the overall HBV infection ranges from 1.8% to 62% 7-15 among adult inmates.Studies conducted with prisoners in Brazil determined HBV seroprevalence ranging from 11.1% to 26.4% 8,11,14,15 .
HBV infection due to the prison lifestyle, including illicit drug use, unsafe sex with multiple sexual the prison inmates by pervasive social health problems, illegal behavior and limited educational opportunities 16,17 .Due to the fact that the penal systems could serve as reservoirs for HBV.In addition, HBV infected inmates may also transmit this virus to the general population 6,17 .
Although knowledge regarding the epidemiological status of HBV infection among the prison population to implement appropriate prevention measures 9 , few studies in this population have been conducted in Brazil 8,11,15,18 investigate the prevalence and associated factors for HBV infection among prison inmates in the State of Mato Grosso do Sul.