Hepatitis B in Wisconsin male prisoners: considerations for serologic screening and vaccination.

To develop a protocol for prevention of hepatitis B virus (HBV) transmission in Wisconsin prisons, we interviewed 619 male prisoners at incarceration to obtain information on hepatitis B risk factors. We defined previous infections by the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), or antibody to hepatitis B core antigen (anti-HBc). Logistic regression was used to develop a model of relative risk (RR) of HBV infection. Use of illicit intravenous (IV) drugs was the most important risk factor because of a high prevalence of IV drug use and an RR which ranged from 2.93-7.47. Other important risk factors were: prior hepatitis or jaundice (RR = 6.28), race (RR = 2.54 for Blacks, RR = 3.28 for Latinos), transfusion (RR = 3.00), and age. Previous imprisonment was not an independent risk factor for HBV, hence selective serologic screening and vaccination of prisoners are justified rather than mass screening and vaccination. Based upon prevalence of hepatiti...