Prevalence and Factors Associated With Hepatitis C in Danish Prisons, 2022-2024: A Multicentre Cross-Sectional Study

Abstract

Prisons offer a critical opportunity for hepatitis C virus (HCV) elimination, yet current data from Danish correctional facilities are sparse. We conducted a cross-sectional study in 16 prisons across Eastern Denmark between October 2022 and August 2024, enrolling 651 incarcerated individuals. All participants underwent HCV antibody and RNA testing using dried blood spots and completed a bio-behavioural risk survey. The prevalence of HCV antibody and HCV RNA was 4.2% (n = 26) and 2.0% (n = 13) respectively. HCV exposure was most prevalent among individuals with a history of injecting drug use (56.4%), women (11.3%) and foreign-born individuals (6.7%). In multivariable logistic regression, HCV exposure was significantly associated with injecting drug use (adjusted odds ratio [aOR] 209.11, 95% confidence interval [CI]: 36.16-1209.27), female sex (male vs. female: aOR 0.18, 95% CI: 0.05-0.60) and being born in a low-prevalence country (aOR 6.22, 95% CI: 1.64-23.61). We observed substantial site-level variation and care gaps that disproportionately affect marginalised groups. These findings support the implementation of targeted HCV screening at prison intake, along with facility-specific and population-tailored interventions, as essential strategies for achieving Denmark's commitment to the World Health Organization's HCV elimination goal.