Feasibility and Outcome of HCV Treatment in a Canadian Federal Prison Population

Farley, John; Vasdev, Shawn; Fischer, Benedikt; Haydon, Emma; Rehm, Jürgen; Farley, Theresa A.

doi:10.2105/ajph.2004.056150

Cited by 42 publications

(41 citation statements)

References 16 publications

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“…Our results were attained despite the high prevalence of alcohol and substance use disorders, high prevalence of psychiatric comorbidities, and the large proportion of ethnic minorities. Our results are similar to the SVR rate of 52% among 59 prisoners in Canada who received standard IFN treatment; more than one-half of the subjects in that study were infected with the “favorable” HCV genotypes 2 or 3, and HIV status was not reported [36]. With regard to other programs that used standard IFN-RBV treatment, the SVR rate was reported to be 29% among 93 prisoners in Rhode Island [46] and 36% among 119 prisoners in Virginia [37]; neither of those studies included HIV-infected prisoners.…”

Section: Discussionsupporting

confidence: 81%

Clinical Outcomes of Hepatitis C Treatment in a Prison Setting: Feasibility and Effectiveness for Challenging Treatment Populations

et al. 2008

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Background More than one-third of people in the United States with hepatic C virus (HCV) infection pass through the correctional system annually. Data are lacking on outcomes of treatment with pegylated interferon plus ribavirin (PEG-RBV) in correctional settings. Methods During 2002–2006, we analyzed patients in the Connecticut Department of Correction who received PEG-RBV. We assessed the rates of sustained virological response, hospitalization, and use of medications to treat psychiatric disorders and anemia. Results Of 138 treatment-naive patients referred for treatment, 68 (49%) were approved. Overall, sustained virological response occurred in 47.1% of patients (for HCV genotype 1, 43.1%; for HCV genotypes 2 and 3, 58.8%). Only 9 patients (13%) discontinued treatment because of adverse effects. Multiple regression analysis revealed that not achieving a sustained virological response was correlated with HCV genotype 1 infection plus cirrhosis (adjusted odds ratio, 12.9; 95% confidence interval, 1.1–148) and baseline major depression (adjusted odds ratio, 3.4; 95% confidence interval, 1.01–11.6), but not with HIV infection, a baseline HCV RNA level ⩾400,000 IU/mL, or black race. Compared with baseline, the rate of prescription of a new mood stabilizer (2.2 vs. 0.8 prescriptions per person-year) or an opioid (1.8 vs. 0.5 prescriptions per person-year) was higher during treatment, whereas there was no change in the rate of prescription of benzodiazepines and antipsychotic medications. Conclusions These results support the feasibility and clinical effectiveness of PEG-RBV for the treatment of chronic HCV infection in correctional facilities.

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Section: Discussionsupporting

confidence: 81%

Clinical Outcomes of Hepatitis C Treatment in a Prison Setting: Feasibility and Effectiveness for Challenging Treatment Populations

et al. 2008

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“…Several commentators have recommended that antiviral therapy can, and should, be delivered in the multidisciplinary primary care setting when focused on areas of high prevalence of HCV. 4,[8][9][10]15,17,[27][28] The findings of the current review have suggested that such primary care-based treatment is feasible with support from specialists. Such a model has treatment outcomes that are equivalent with secondary care services.…”

Section: Discussion Summarymentioning

confidence: 99%

“…Service evaluations of prison-based antiviral treatment have been conducted in the US 27 and Canada, 28 where SVR rates using intention-to-treat analysis was 48% (70% genotype 1) and 51.8% respectively. Both studies concluded that correctional facilities provided an ideal opportunity to diagnose and treat patients with CHC in combination with preventative measures.…”

Section: Antiviral Treatment Provision In Custodial Settingsmentioning

confidence: 99%

Can antiviral treatment for hepatitis C be safely and effectively delivered in primary care?

Brew

Butt²,

Wright³

2013

Br J Gen Pract

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“…Studies performed in custodial settings show acceptable results and sustained viral response (SVR) rates ranging between 36% and 66% [44-49]. …”

Section: Hcv Treatment For Prisonersmentioning

confidence: 99%

Hepatitis C in European prisons: a call for an evidence-informed response

2014

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Globally, over 10 million people are held in prisons and other places of detention at any given time. People who inject drugs (PWID) comprise 10-48% of male and 30-60% of female prisoners. The spread of hepatitis C in prisons is clearly driven by injection drug use, with many infected prisoners unaware of their infection status. Risk behaviour for acquisition of hepatitis C via common use of injecting equipment is widespread in many prison settings.In custodial settings, effective and efficient prevention models applied in the community are very rarely implemented. Only approximately 60 out of more than 10,000 prisons worldwide provide needle exchange. Thus, HCV prevention is almost exclusively limited to verbal advice, leaflets and other measures directed to cognitive behavioural change. Although the outcome of HCV antiviral treatment is comparable to non-substance users and substance users out of prison, the uptake for antiviral treatment is extremely low.Based on a literature review to assess the spread of hepatitis C among prisoners and to learn more about the impact for the prison system, recommendations regarding hepatitis C prevention, screening and treatment in prisons have been formulated in this article.

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Feasibility and Outcome of HCV Treatment in a Canadian Federal Prison Population

Cited by 42 publications

References 16 publications

Clinical Outcomes of Hepatitis C Treatment in a Prison Setting: Feasibility and Effectiveness for Challenging Treatment Populations

Clinical Outcomes of Hepatitis C Treatment in a Prison Setting: Feasibility and Effectiveness for Challenging Treatment Populations

Can antiviral treatment for hepatitis C be safely and effectively delivered in primary care?

Hepatitis C in European prisons: a call for an evidence-informed response

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