TY - JOUR
T1 - Treatment with direct-acting antivirals in a multicenter cohort of HCV-infected inmates in Italy
AU - Gruppo Infettivologi Penitenziari
AU - Pontali, Emanuele
AU - Fiore, Vito
AU - Ialungo, Anna Maria
AU - Ranieri, Roberto
AU - Mollaretti, Oscar
AU - Barbarini, Giorgio
AU - Marri, Daniele
AU - Prestileo, Tullio
AU - Dell'Isola, Serena
AU - Rastrelli, Elena
AU - Leo, Guido
AU - Starnini, Giulio
AU - Babudieri, Sergio
AU - Madeddu, Giordano
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: People who are incarcerated have a significantly higher prevalence of HCV infection than the general population. Given their high-risk behavior, they represent a reservoir of HCV infection for the whole community. Methods: We evaluated all HCV-infected people who were incarcerated in 25 Italian prisons starting direct-acting antivirals (DAAs) treatment between May 2015 and October 2016. We collected information on demographic characteristics, liver disease, HCV-related aspects, anti-HCV treatment, HIV or HBV co-infection. Results: We enrolled 142 incarcerated people treated with DAAs. They were mostly Italians (93.7%) and males (98.6%). Median age was 50 years and 108/142 (76.1%) were cirrhotic patients. Prevalent genotypes were 1a (35.9%) and 3 (35.9%). Two patients were HBV co-infected, twenty-one patients (14.8%) were HIV co-infected and almost all (95.2%) received antiretroviral therapy. 118/142 (83.1%) DAAs-based regimens included sofosbuvir. Treatment completion rate was 94.4%. There were eight (5.6%) discontinuations, one (0.7%) due to an adverse reaction, one due to death (0.7%) and six (5.6%) due to release from prison. SVR12 was achieved in 90.8%. Four patients relapsed but no breakthrough occurred. Conclusions: Our study shows that in Italian penitentiary settings DAAs treatment is feasible and effective. This intervention is crucial for reducing HCV circulation with possible benefits to the general population.
AB - Background: People who are incarcerated have a significantly higher prevalence of HCV infection than the general population. Given their high-risk behavior, they represent a reservoir of HCV infection for the whole community. Methods: We evaluated all HCV-infected people who were incarcerated in 25 Italian prisons starting direct-acting antivirals (DAAs) treatment between May 2015 and October 2016. We collected information on demographic characteristics, liver disease, HCV-related aspects, anti-HCV treatment, HIV or HBV co-infection. Results: We enrolled 142 incarcerated people treated with DAAs. They were mostly Italians (93.7%) and males (98.6%). Median age was 50 years and 108/142 (76.1%) were cirrhotic patients. Prevalent genotypes were 1a (35.9%) and 3 (35.9%). Two patients were HBV co-infected, twenty-one patients (14.8%) were HIV co-infected and almost all (95.2%) received antiretroviral therapy. 118/142 (83.1%) DAAs-based regimens included sofosbuvir. Treatment completion rate was 94.4%. There were eight (5.6%) discontinuations, one (0.7%) due to an adverse reaction, one due to death (0.7%) and six (5.6%) due to release from prison. SVR12 was achieved in 90.8%. Four patients relapsed but no breakthrough occurred. Conclusions: Our study shows that in Italian penitentiary settings DAAs treatment is feasible and effective. This intervention is crucial for reducing HCV circulation with possible benefits to the general population.
KW - Direct acting antivirals
KW - Hepatitis C virus
KW - Inmates
KW - Prison settings
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U2 - 10.1016/j.drugpo.2018.06.017
DO - 10.1016/j.drugpo.2018.06.017
M3 - Article
AN - SCOPUS:85049490321
VL - 59
SP - 50
EP - 53
JO - International Journal of Drug Policy
JF - International Journal of Drug Policy
SN - 0955-3959
ER -