Continuum of hepatitis C care cascade in prison and following release in the direct-acting antivirals era.
HCV elimination
HCV treatment
Harm reduction
Hepatitis C virus (HCV)
Linkage to care
Prison healthcare
Journal
Harm reduction journal
ISSN: 1477-7517
Titre abrégé: Harm Reduct J
Pays: England
ID NLM: 101153624
Informations de publication
Date de publication:
20 10 2020
20 10 2020
Historique:
received:
04
08
2020
accepted:
13
10
2020
entrez:
21
10
2020
pubmed:
22
10
2020
medline:
29
10
2021
Statut:
epublish
Résumé
People with criminal justice involvement contribute remarkably to the rising hepatitis C virus (HCV) burden; however, the continuum of care is a major barrier to prison-based programs. We aimed to evaluate a comprehensive HCV care model in an Iranian provincial prison. Between 2017-2018, in the Karaj Central Prison, newly admitted male inmates received HCV antibody testing and venipuncture for RNA testing (antibody-positive only). Participants with positive RNA underwent direct-acting antiviral (DAA) therapy (Sofosbuvir/Daclatasvir). Sustained virological response was evaluated at 12 weeks post-treatment (SVR12). Overall, from 3485 participants, 182 (5.2%) and 117 (3.4%) tested positive for HCV antibody and RNA, respectively. Among 116 patients who were eligible for treatment, 24% (n = 28) were released before treatment and 72% (n = 83) initiated DAA therapy, of whom 81% (n = 67/83) completed treatment in prison, and the rest were released. Of total released patients, 68% (n = 30/44) were linked to care in community, and 70% (n = 21/30) completed treatment, including 60% (n = 12/20) and 90% (n = 9/10) among those who were released before and during treatment, respectively. The overall HCV treatment uptake and completion were 89% (n = 103/116) and 85% (n = 88/103), respectively. From people who completed treatment, 43% (n = 38/88) attended for response assessment and all were cured (SVR12 = 100%). Integrated HCV care models are highly effective and can be significantly strengthened by post-release interventions. The close collaboration of community and prison healthcare systems is crucial to promote high levels of treatment adherence. Future studies should investigate the predictors of engagement with HCV care following release.
Sections du résumé
BACKGROUND
People with criminal justice involvement contribute remarkably to the rising hepatitis C virus (HCV) burden; however, the continuum of care is a major barrier to prison-based programs. We aimed to evaluate a comprehensive HCV care model in an Iranian provincial prison.
METHODS
Between 2017-2018, in the Karaj Central Prison, newly admitted male inmates received HCV antibody testing and venipuncture for RNA testing (antibody-positive only). Participants with positive RNA underwent direct-acting antiviral (DAA) therapy (Sofosbuvir/Daclatasvir). Sustained virological response was evaluated at 12 weeks post-treatment (SVR12).
RESULTS
Overall, from 3485 participants, 182 (5.2%) and 117 (3.4%) tested positive for HCV antibody and RNA, respectively. Among 116 patients who were eligible for treatment, 24% (n = 28) were released before treatment and 72% (n = 83) initiated DAA therapy, of whom 81% (n = 67/83) completed treatment in prison, and the rest were released. Of total released patients, 68% (n = 30/44) were linked to care in community, and 70% (n = 21/30) completed treatment, including 60% (n = 12/20) and 90% (n = 9/10) among those who were released before and during treatment, respectively. The overall HCV treatment uptake and completion were 89% (n = 103/116) and 85% (n = 88/103), respectively. From people who completed treatment, 43% (n = 38/88) attended for response assessment and all were cured (SVR12 = 100%).
CONCLUSIONS
Integrated HCV care models are highly effective and can be significantly strengthened by post-release interventions. The close collaboration of community and prison healthcare systems is crucial to promote high levels of treatment adherence. Future studies should investigate the predictors of engagement with HCV care following release.
Identifiants
pubmed: 33081794
doi: 10.1186/s12954-020-00431-x
pii: 10.1186/s12954-020-00431-x
pmc: PMC7576794
doi:
Substances chimiques
Antiviral Agents
0
Hepatitis C Antibodies
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
80Références
Lancet Infect Dis. 2018 Feb;18(2):215-224
pubmed: 29153265
Addiction. 2017 Jul;112(7):1302-1314
pubmed: 28257600
BMC Infect Dis. 2019 Aug 8;19(1):703
pubmed: 31395019
Lancet. 2016 Sep 10;388(10049):1089-1102
pubmed: 27427453
BMJ Open. 2019 Jul 24;9(7):e030546
pubmed: 31345984
PLoS One. 2020 Apr 10;15(4):e0231211
pubmed: 32275680
Public Health Rep. 2014 Jan-Feb;129 Suppl 1:5-11
pubmed: 24385643
J Viral Hepat. 2020 Feb;27(2):205-220
pubmed: 31638294
Public Health Rep. 2016 May-Jun;131 Suppl 2:98-104
pubmed: 27168668
Am J Public Health. 2018 Mar;108(3):385-392
pubmed: 29345992
Int J Drug Policy. 2018 Jul;57:95-103
pubmed: 29715590
Hepat Mon. 2016 May 03;16(6):e37011
pubmed: 27630727
PLoS One. 2019 Sep 11;14(9):e0222186
pubmed: 31509571
Health Justice. 2018 Mar 2;6(1):4
pubmed: 29500640
JAMA. 2009 Feb 25;301(8):848-57
pubmed: 19244192
Public Health Rep. 2007;122 Suppl 2:83-8
pubmed: 17542460
J Viral Hepat. 2018 Dec;25(12):1406-1422
pubmed: 30187607
Int J Drug Policy. 2018 Sep;59:50-53
pubmed: 29986272
Health Justice. 2017 Oct 30;5(1):10
pubmed: 29086078
Am J Public Health. 2015 Feb;105(2):351-7
pubmed: 25521890
J Clin Virol. 2019 Apr;113:20-23
pubmed: 30825832
BMJ Open. 2016 Jan 14;6(1):e010125
pubmed: 26769790
Addiction. 2018 Mar;113(3):545-563
pubmed: 28891267
Infection. 2017 Apr;45(2):131-138
pubmed: 28025726
Int J Drug Policy. 2018 Dec;62:74-77
pubmed: 30368101
Am J Public Health. 2011 Dec;101 Suppl 1:S347-52
pubmed: 22039042
Harm Reduct J. 2020 Aug 14;17(1):56
pubmed: 32795371
J Public Health (Oxf). 2016 Mar;38(1):130-7
pubmed: 25736438
Adm Policy Ment Health. 2016 Mar;43(2):207-18
pubmed: 25663094
Trials. 2017 Aug 4;18(1):365
pubmed: 28778175
J Viral Hepat. 2016 Dec;23(12):1009-1016
pubmed: 27509844
Int J Drug Policy. 2019 Oct;72:123-128
pubmed: 30967329
J Urban Health. 2010 Jul;87(4):603-16
pubmed: 20390391
J Viral Hepat. 2016 Jun;23(6):473-8
pubmed: 26856967
Clin Infect Dis. 2018 Jul 18;67(3):460-463
pubmed: 29538639
Subst Abus. 2018;39(4):461-468
pubmed: 29949450
Sci Rep. 2018 Jan 9;8(1):150
pubmed: 29317673
Epidemiol Rev. 2018 Jun 1;40(1):58-69
pubmed: 29860343
Harm Reduct J. 2018 May 9;15(1):24
pubmed: 29739400
Lancet HIV. 2018 Feb;5(2):e96-e106
pubmed: 29191440
Int J Law Psychiatry. 2011 Jul-Aug;34(4):249-55
pubmed: 21802731
Trop Med Int Health. 2018 Jun;23(6):641-649
pubmed: 29698576