Reinfection in a large cohort of prison inmates with sustained virological response after treatment of chronic hepatitis C in Catalonia (Spain), 2002–2016

Marco, A; Guerrero, Rafael; Vergara, Mercedes; Gallego, C; Solé, Concepció; Planella, Ramón; Vaz, Marta; Teixidó, Núria; Sastre, Ana María Calvo; Touzón, Carlos; Silva, Antônio da; Almada, Guido; Ruiz, Ana Cano; Caylà, Joan A.; Turu, E

doi:10.1016/j.drugpo.2019.05.014

Cited by 16 publications

(15 citation statements)

References 29 publications

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“…Incarcerated patients, particularly those with injection substance use, were reported to have high overall incidence of reinfection after successful treatment [ 39 , 40 ]. This issue warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

Micro-elimination of Chronic Hepatitis C by Universal Screening plus Direct Acting Antivirals for Incarcerated Persons in Taiwan

Yang

Fang

Hsu

et al. 2020

Open Forum Infectious Diseases

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Background Incarcerated persons are a special population with higher hepatitis C virus (HCV) prevalence and should be prioritized for micro-elimination. This study aimed to investigate the seroprevalence and to evaluate the effectiveness and safety of direct acting antiviral (DAA) therapy in the custodial settings. Methods Incarcerated persons in Yunlin Prison were recruited to receive anti-HCV antibody screening. Patients with positive HCV ribonucleic acid (HCV RNA) were treated with glecaprevir/pibrentasvir (GLE/PIB) in our special chronic hepatitis C (CHC) clinic in prison. The primary endpoint was sustained virologic response at week 12 off therapy (SVR12). Results A total of 1402 incarcerated persons were invited to anti-HCV screening and 824 (58.7%) accepted. The prevalence of anti-HCV positivity was 33.5% (276/824) and the viremic rate (detectable HCV RNA) was 69.2% (191/276). According to FIB-4 index, patients with F3 stage were six (3.1%), but none met the criteria of F4 stage. However, six (3.1%) had liver cirrhosis with splenomegaly, confirmed by findings of ultrasonography. The median log10 HCV RNA level at baseline was 6.235 (2.394-7.403). Genotype (GT) 6 was predominant (39.3%), followed by GT 1a (22.0%) and 1b (14.1%). Mixed genotype HCV infection accounted for 3.6% of total infections. In total, 165 patients received GLE/PIB therapy. The overall SVR12 rates were 100%. Conclusions DAA therapy is highly effective and safe for incarcerated patients in Taiwan. Our special prison-based CHC clinic, linking universal screening to medical care, can serve as a model for micro-elimination of HCV in custodial settings.

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Section: Discussionmentioning

confidence: 99%

Micro-elimination of Chronic Hepatitis C by Universal Screening plus Direct Acting Antivirals for Incarcerated Persons in Taiwan

Yang

Fang

Hsu

et al. 2020

Open Forum Infectious Diseases

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“…Otra posible limitación del trabajo es que no se han tenido en cuenta los casos de reinfección post-RVS. En España, se ha estudiado recientemente la reinfección en más de 600 presos tratados con RVS en los que pudo hacerse un seguimiento, estimándose que la tasa de reinfección en este grupo es de 2,9 por 100 pacientes/año 40 . Este dato es relevante epidemiológicamente, y debería suponer el retratamiento preferiblemente temprano de estos pacientes.…”

Section: Discussionunclassified

“…Another possible limitation of this work is that cases of post-SVR reinfection were not taken into account. In Spain, reinfection has recently been studied in more than 600 prisoners treated with SVR for whom monitoring was possible, and it was found that the estimated reinfection rate for this group was 2.9 per 100 patients/year 40 . These data are epidemiologically relevant and should support the preferably early re-treatment of these patients.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of chronic hepatitis C treatment in the prison population in Spain

Marco

Domínguez-Hernández

Casado

2020

Rev Esp Sanid Penit

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Evaluar, en presos con hepatitis C crónica (HCc) pendientes de tratamiento, el coste-efectividad de tratarlos con antivirales de acción directa (AAD) frente a no tratarlos, y analizar el impacto clínico y económico del tratamiento sobre las complicaciones hepáticas y la mortalidad. Material y método: Se desarrolló un modelo de Markov para simular el tratamiento y proyectar la progresión de la enfermedad de una cohorte estimada de 4.408 reclusos con HCc tratados con AAD en dos años (el 50% cada año) frente a ningún tratamiento. En los tratados, se asoció una respuesta viral sostenida del 95%. Las características de los pacientes, las probabilidades de transición, las utilidades y los costes (farmacológicos y estados de salud) se obtuvieron de publicaciones científicas. El modelo estimó costes y resultados en salud, la relación coste-utilidad incremental (RCUI), a partir de los costes totales y años de vida ajustados por calidad (AVAC) y los eventos clínicos evitados. La perspectiva fue la del Sistema Nacional de Salud (SNS) y se aplicó una tasa de descuento anual (el 3%) para costes y resultados en salud. La robustez de los resultados se evaluó mediante un análisis de sensibilidad. Resultados: En la población tratada, el modelo estimó una reducción del 92% de los casos de cirrosis descompensada y del 83% de carcinoma hepatocelular, se evitaron 132 trasplantes hepáticos y disminuyó el 88% la mortalidad hepática. El tratamiento consiguió 5,0/AVAC adicionales (21,2 frente al 16,2), con un coste incremental de 3.473 euros (24.088 € frente a 20.615 €) por paciente y una RCUI de 690 €/AVAC ganado. Discusión: Considerando el umbral de disponibilidad a pagar utilizado en España (22.000-30.000 €/AVAC), el tratamiento con AAD en los presos con HCc es una estrategia altamente coste-efectiva, reduce la transmisión, aumenta la supervivencia y reduce las complicaciones hepáticas, así como los costes asociado a su manejo.

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“…Nineteen studies were identified assessing recurrence in high-risk patients who achieved SVR following DAAs therapy. 14,15,21,[27][28][29][45][46][47][48][49][50][51][52][53][54][55][56][57] The median follow-up time post-SVR was 17 months (interquartile range, 9-21). Of those studies, four evaluated the risk in prisoners, 15,49,53,56 S2).…”

Section: High-risk Hcv-mono-infected Populationmentioning

confidence: 99%

“…14,15,21,[27][28][29][45][46][47][48][49][50][51][52][53][54][55][56][57] The median follow-up time post-SVR was 17 months (interquartile range, 9-21). Of those studies, four evaluated the risk in prisoners, 15,49,53,56 S2).…”

Section: High-risk Hcv-mono-infected Populationmentioning

confidence: 99%

The risk of hepatitis C virus recurrence in hepatitis C virus‐infected patients treated with direct‐acting antivirals after achieving a sustained virological response: A comprehensive analysis

Huang

Wang

Yue

et al. 2021

Liver International

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Background & Aims The risk for hepatitis C virus (HCV) recurrence persists after HCV eradication with direct‐acting antivirals (DAAs), particularly in patients with ongoing high‐risk behaviours. Our aim was to assess the risk of HCV recurrence (late relapse and/or reinfection) post‐sustained virological response (SVR). Methods We searched the literature for studies reporting HCV recurrence rates post‐SVR in PubMed, Web of Science and the Cochrane Library. Identified publications were divided into groups based on patient risk for HCV reinfection: low‐risk HCV mono‐infection, high‐risk HCV mono‐infection and a human immunodeficiency virus (HIV)/HCV coinfection. The HCV recurrence rate for each study was calculated by using events divided by the person‐years of follow‐up (PYFU). HCV recurrence was defined as confirmed, detectable HCV RNA post‐SVR. Results In the 16 studies of low‐risk patients, the pooled recurrence rate was 0.89/1000 PYFU (95% confidence interval [CI], 0.16‐2.03). For the 19 studies of high‐risk patients, the pooled recurrence rate was 29.37/1000 PYFU (95% CI, 15.54‐46.91). For the eight studies of HIV/HCV‐coinfected patients, the pooled recurrence rate was 23.25/1000 PYFU (95% CI, 4.24‐53.39). The higher pooled estimates of recurrence in the high‐risk and HIV/HCV‐coinfected populations were predominantly driven by an increase in reinfection rather than late relapse. Conclusions The HCV recurrence risk after achieving SVR with all‐oral DAAs therapy is low, and the risk of HCV recurrence in high‐risk and HIV/HCV‐coinfected populations was driven by an increase in reinfection rather than late relapse.

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Reinfection in a large cohort of prison inmates with sustained virological response after treatment of chronic hepatitis C in Catalonia (Spain), 2002–2016

Cited by 16 publications

References 29 publications

Micro-elimination of Chronic Hepatitis C by Universal Screening plus Direct Acting Antivirals for Incarcerated Persons in Taiwan

Micro-elimination of Chronic Hepatitis C by Universal Screening plus Direct Acting Antivirals for Incarcerated Persons in Taiwan

Cost-effectiveness analysis of chronic hepatitis C treatment in the prison population in Spain

The risk of hepatitis C virus recurrence in hepatitis C virus‐infected patients treated with direct‐acting antivirals after achieving a sustained virological response: A comprehensive analysis

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