Ghana Prison Study Finds High HBV Infectivity Markers

A cross-sectional secondary analysis of archived plasma samples from incarcerated individuals in Ghana has identified a substantial prevalence of serological markers associated with hepatitis B virus infectivity and recent infection. The study, published in BMC Infectious Diseases, examined 323 samples from inmates who tested positive for the hepatitis B surface antigen, commonly known as HBsAg. The research aimed to evaluate the presence of hepatitis B e antigen, or HBeAg, and immunoglobulin M antibodies to hepatitis B core antigen, referred to as anti-HBc IgM, within this specific population. Correctional facilities are often recognized as high-risk environments for the transmission of blood-borne infections due to factors such as overcrowding, high-risk behaviors, and limited access to healthcare services.

The study was conducted as a secondary analysis, utilizing data and biological samples collected during a nationwide prison survey. The researchers focused on a cohort of 323 individuals who had previously been identified as HBsAg-positive.

The laboratory methods employed in this analysis involved enzyme-linked immunosorbent assays, or ELISAs, to detect the presence of HBeAg and anti-HBc IgM in the archived plasma samples.

The results of the analysis revealed that 91 out of the 323 HBsAg-positive samples, representing 28.2 percent, were positive for HBeAg. This finding indicates that more than a quarter of the HBsAg-positive inmates in the study had serological evidence of increased viral infectivity. Additionally, 16 samples, or 5.0 percent, tested positive for anti-HBc IgM. This smaller proportion suggests that a subset of the population may have experienced recent infection or a reactivation of chronic disease. The statistical analysis further showed that HBeAg positivity was significantly associated with the type of prison and the duration of incarceration, with p-values less than 0.001 and 0.05, respectively.

Regarding the anti-HBc IgM marker, the study found that most inmates who tested positive for this antibody had been incarcerated for more than one year. However, the researchers noted that no significant associations were observed between anti-HBc IgM positivity and the demographic variables examined in the study.

The study design, being cross-sectional, has inherent limitations that the authors carefully addressed in their conclusion. In this context, the absence of pre-incarceration serological data precludes the confirmation that transmission occurred specifically within the prison. Although these findings highlight the potential for HBV transmission within correctional facilities, the cross-sectional design and absence of pre-incarceration serological data preclude confirmation of intra-prison transmission.

The study suggests that strengthened HBV screening, vaccination programs, and clinical management are warranted to mitigate the risk of transmission. Furthermore, the researchers recommend longitudinal studies that incorporate HBV DNA testing to better characterize the dynamics of HBV transmission in correctional settings.

Subject of Research: Serological markers of HBV infectivity and recent infection among HBsAg-positive inmates in Ghanaian correctional facilities

Article Title: Prevalence and correlates of serological markers of HBV infectivity and recent infection among HBsAG-positive inmates in Ghanaian correctional facilities

Article References: Ayiku, A. N. A., Pappoe-Ashong, P. J., Dzabeng, F., Ahene, A., Seshie, M., Boamah, I., & Sagoe, K. W. C. (2026). Prevalence and correlates of serological markers of HBV infectivity and recent infection among HBsAG-positive inmates in Ghanaian correctional facilities. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14548-0

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DOI: 10.1186/s12879-026-14548-0

Keywords: hepatitis B, correctional facilities, serology, HBeAg, anti-HBc IgM, Ghana, infectious disease, prison health, cross-sectional study, HBV transmission, Prevalence, correlates