Hepatitis C management in prisons: An insight into daily clinical practice in three major Italian correctional houses

Abstract

AO, et al. Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort study. Gut 2015;

Microenvironment Eradication of Hepatitis C: A Novel Treatment Paradigm

“…Previous experiences have demonstrated that HCV treatment in incarcerated populations is feasible and meets the standard criteria for cost-effectiveness [12,24]. A recent report describes the experience in three major Italian prisons of a program of test and treat chronic HCV inmates with DAAs only for those with advanced disease (F3-F4) according to Italian guidelines [7]. The "El Dueso" experience goes further in terms of extending treatments to all fibrosis stages, universal use of DAAs, and sustainability of the program over time, intending to become a real HCV-reservoir elimination program.…”

“…lower (15.5% and 15.3%, respectively) [6]. Some intrinsic circumstances aggravate the problem, such as a substantial risk of HCV transmission during incarceration and after release, favored in part by an unawareness rate up to 25% [7].…”

“…It has been recently advocated that a strategy based on "microelimination" programs targeted on risk populations like prisoners may allow authorities to achieve the World Health Organization (WHO) commitment of eliminating viral hepatitis B and C as public health threats by 2030 [11]. Up to now, there have been some experiences of epidemiological surveillance and even treatment programs in selected prisons [7,12]. Nevertheless, they all lack generalization or even maintenance of these programs, probably due to the aforementioned barriers.…”

Comparison of effectiveness and discontinuation of interferon‐free therapy for hepatitis C in prison inmates and noninmates

“…DAA treatment in prisoners is very attractive because it is effective, safe and short term. However, there are very few reports of its use in the prison environment: to our knowledge, only 1 letter, 2 congress presentations and 2 pharmacoeconomic studies have been published. Probably, the scarcity of results is related to the more limited access to treatment of inmates, for economic reasons .…”

“…In inmates the main cause of discontinuation was release from prison, in which case information regarding the completion of the treatment and the achievement of SVR was very often lost. The difficulty of continuing the treatment after release has often been cited 8,19,[26][27][28][29] and is the main obstacle to obtaining SVR when the treatment is initiated in prison. This problem was also cited by McDonald 20 and Bouteille-Gaillet, 21 who reported rates of missing cases due to release of 28% and 27%, respectively.…”