Personality disorders do not affect treatment outcomes for chronic HCV infection in Spanish prisoners: the Perseo study

Marco, A; Antón, J.; Trujols, Joan; Hoya, Pablo Saíz de la; Juan, José de; Faraco, I; Caylà, Joan A.

doi:10.1186/s12879-015-1102-x

Cited by 5 publications

(6 citation statements)

References 44 publications

(40 reference statements)

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“…That is why the discontinuation rate due to side effects was not higher in these incarcerated patients. As the Spanish study described, the personality disorder did not affect discontinuation and SVR for chronic HCV infection in prisoners [21].…”

Section: Discussionmentioning

confidence: 69%

Implementation of Treating Chronic Hepatitis C in a Correcting Institute by a Hospital-Backup Clinic

Lin¹,

Chan²,

Nguang³

2018

SJPH

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Background: chronic viral hepatitis C (HCV) is endemic in the correctional facilities due to intravenous drug use (IDU). In Taiwan, the health insurance reimbursed the interferon-based dual therapy for chronic HCV in the correcting institute since Jan 2013. Therefore, this work is to investigate the feasibility and safety of a hospital-backup clinic care to treat HCV with dual therapy in a correcting facility. Pingtung Christian Hospital established regular clinics on weekdays inside this correcting facility, and offered the computer system, physicians, clinical nurses, laboratory and pharmacy. The chronic HCV infected prisoner was cared in a regular hepatitis clinic, the consultation, blood test, serology and virology test, sonogram, interferon injection were implemented in the clinics, but EPO and transfusion was not offered. Prisoners, who had the will and fitted the indication/contra-indication of interferon-based therapy, were enrolled for treatment. The therapy was guided by Taiwan health insurance guideline---Pegasys 180 mcg/week combined ribavirin 15 mg/kg/day for 6 months if rapid viral response (RVR) achieved, and 12 months if RVR not achieved but early viral response achieved regardless of genotype. From Apr 2013 to Dec 2016, 103 voluntary prisoners, mean 39.3 ± 5.9 years old, all male and IDU, were enrolled for dual therapy. All the treatment-related events were managed inside the facility and the most common side effects of therapy is skin rash with itching in which anti-histamine medication was necessary but did not cause withdrawing. The rapid viral response rate was achieved in 70.9% of treatment inmates, 11 patients withdrew from therapy due to 4 influenza-like side effects, 1insomnia, 1 hyperthyroidism, 1 flared psoriasis, 2 early releases and 2 transferring prison. Among the 92 cases of complete treatment, 8 patients lose SVR follow-up owing to 5 transferring and 3 early releasing. SVR was achieved in 80 patients. The per-protocol and intention-to-treat SVR is 95.2% (80/84) and 82.7% (85/103) respectively. Five patients of the 7 withdrawers achieved SVR in spite of incomplete therapy due to side effect. All of the side effect could be managed in the clinic. In conclusion, this model of hospital back-up clinic to execute interferon-based therapy for chronic HCV infected inmates was feasible and it achieves excellent eradication rate. But early release and transferring prison may interfere the comprehensive treatment and post-treatment following up, the efforts to improve the coordination between correction institutes or community should be made.

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Section: Discussionmentioning

confidence: 69%

Implementation of Treating Chronic Hepatitis C in a Correcting Institute by a Hospital-Backup Clinic

Lin¹,

Chan²,

Nguang³

2018

SJPH

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“…Our study confirms the high overall SVR achieved in clinical practice, not only in general population but also in prisoners. Many previous studies have assessed the use of pegylated interferon and ribavirin in inmates . Rice et al compared inmates and non‐inmates treated with interferon and ribavirin and found similar results in the two populations despite the differences between them .…”

Section: Discussionmentioning

confidence: 97%

“…Many previous studies have assessed the use of pegylated interferon and ribavirin in inmates. [11][12][13][14][15][16][17][18] Rice et al compared inmates and non-inmates treated with interferon and ribavirin and found similar results in the two populations despite the differences between them. 14 DAA treatment in prisoners is very attractive because it is effective, safe and short term.…”

Section: Discussionmentioning

confidence: 99%

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

Marco¹,

Roget

Cervantes

et al. 2018

Journal of Viral Hepatitis

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Chronic hepatitis C treatment with direct acting antiviral (DAA) therapy during incarceration is an attractive option, due to its short duration and to the possibility of directly observed treatment or supervision. The aim of this study is to compare the effectiveness and rates of discontinuation of DAA treatment in prisoners and nonprisoners. We studied all patients treated in the 10 prisons of Catalonia and at 3 public hospitals in the Barcelona area between 1 January 2015 and 30 April 2016. We analysed sustained viral response (SVR) and rates of discontinuation through intention-to-treat and modified-intention-to-treat analyses, the latter excluding discontinuations due to release from prison. One hundred and eighty-eight inmates and 862 noninmates were included. Prisoners were significantly younger than nonprisoners, with higher proportions of men, drug users, HIV infection, genotypes 1a and 3 and more treatment with psychiatric drugs. Overall, 98.4% of patients completed treatment. The discontinuation rate was low, but higher in inmates (3.7% vs 1.2% noninmates; P = .003) and in community patients >65 years old (2.8% vs 1.2% in under 65 seconds; P = .008). Among the inmates, 7 (42.8%) discontinuations were due to release. SVR was 93.1% in inmates vs 96.5% in noninmates (P = .08) by intention-to-treat and 95.1% vs 96.5% (P = .37) by modified intention-to-treat. Virologic failure rates were similar (3.8% vs 3% in noninmates; P = .60). SVR, virologic failure and discontinuation rates were similar in inmates and noninmates. Currently, prisons are considered a priority for the implementation of DAA. Improved coordination between penitentiary and community health systems would help to ensure therapeutic continuity in released prisoners.

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“…One type of personality disorder (the antisocial type) was found in as many as 14.7% of patients on opioid substitution treatment at a Malaysian university hospital (9). On the other hand, the prevalence of HCV infection among patients on opioid substitution treatment is high, varying from 70 to 72.51% (10,11). Although it has been previously shown that personality disorders are risk factors for HCV infection, e.g., in prisons (11,12), it remains uncertain whether personality malfunction is a risk factor for HCV infection and, if such a link exists, whether it is working in a subpopulation of opioid substitution treatment subjects regardless of whether or not the patients were diagnosed with personality disorders.…”

Section: Introductionmentioning

confidence: 99%

Personality dysfunction in opiate addicts on opioid substitution treatment and the risk of HCV infection

Skočibušić

Zivlak-Radulovic

Hasanović

et al. 2022

Front. Public Health

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BackgroundImpulsivity, affective instability, and neglect of oneself and other people's safety as symptoms of personality dysfunction are associated with risky behaviors regarding the transmission of infectious diseases either sexually or by intravenous drug abuse.ObjectiveThe aim of this study was to analyze the association between hepatitis C virus (HCV) infection and personality dysfunction in opiate addicts on opioid substitution treatment.MethodsThis was a cross-sectional, observational investigation of patients over 18 years of age who were actively participating in opioid substitution treatment at five centers in Bosnia and Herzegovina. The occurrence of HCV infection was the primary study outcome, and personality functioning, the main independent variable, was assessed using the Severity Indices of Personality Problems (SIPP−118) questionnaire. The association between scores of personality functioning domains items and HCV infection status was determined by binary logistic regression analysis.ResultsPatients on opioid substitution therapy with HCV infection more frequently had personality disorders (OR 2.168, 95% CI 1.161–4.05) and were treated longer than patients without HCV infection (OR 1.076, 95% CI 1.015–1.14). HCV infection was associated with lower self-respect (OR 0.946, 95% CI 0.906–0.988), decreased capacity to have enduring relationships with other people (OR 0.878, 95% CI 0.797–0.966), and lower capability to cooperate with others (OR 0.933, 95%CI 0.888–0.98). On the other hand, except for self-respect, other elements of the Identity Integration domain (enjoyment, purposefulness, stable self-image, and self-reflexive functioning), when more functional, increased the risk of HCV infection.ConclusionsOur study demonstrates that opiate addicts on opioid substitution treatment have a higher risk of HCV infection if their personality is dysfunctional, especially in the aspects of self-respect, enduring relationships, and cooperativity. The risk is even higher in addicts who have an established diagnosis of any kind of personality disorder.

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Personality disorders do not affect treatment outcomes for chronic HCV infection in Spanish prisoners: the Perseo study

Cited by 5 publications

References 44 publications

Implementation of Treating Chronic Hepatitis C in a Correcting Institute by a Hospital-Backup Clinic

Implementation of Treating Chronic Hepatitis C in a Correcting Institute by a Hospital-Backup Clinic

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

Personality dysfunction in opiate addicts on opioid substitution treatment and the risk of HCV infection

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