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People in prisons are at high risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection.

This study aimed to evaluate the prevalence of HBV and HCV exposure and associated risk factors in Iranian prisons.

This cross-sectional study was conducted in 2016, among 29 prisons in Iran, blood samples were collected using multistage sampling. HBV and HCV diagnostic tests were conducted using enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate logistic regression were used for the evaluation of factors associated with HBV and HCV exposure.

Among 6,481 people in prisons, the prevalence of HCV and HBV antibodies were 8.21% (95% CI: 7.55 - 8.90) and 3.06% (95% CI: 2.65 - 3.50), respectively. Based on multivariate analysis, the most important risks associated for HCV exposure were the history of drug use (AOR 5.75, 95% CI 3.54 - 9.35) followed by the age of 30 years and older (AOR: 5.02, 95% CI: 3.65 - 6.9), the history of tattooing (AOR 2.42, 95% CI 1.96 - 3), the history of imprisonment (AOR 2.23, 95%CI 1.76 - 2.82), being single (AOR 1.91, 95% CI 1.54 - 2.37), low education (AOR 1.81, 95%CI 1.01 - 3.27), and the history of piercing (AOR 1.26, 95% CI 1.04 - 1.52). There was no significant association between HBV prevalence and independent variables (P > 0.05).

These findings highlight a high prevalence of HCV infection in Iranian prisons. Efforts are needed to improve HCV screening and interventions, particularly among people with a history of drug use, and linkage to care.