HCV in Prisoners: What Is the Prevalence?

“An unmet objective in the pursuit of HCV elimination is the creation of a simple and fast operating model to identify difficult-to-treat populations, like prisoners. Of many obstacles, the first is represented by the poor knowledge of inmates HCV-Ab prevalence. Moreover, due to the peculiar status of conviction, often their access to antiviral therapy is neglected,” the authors wrote.

They conducted a prospective observational study in order to evaluate the prevalence of HCV infection in 670 patients from a penitentiary in Italy. The study had 2 phases: prisoners clinical records were reviewed to verify HCV antibody (HCV-Ab) execution, followed by a universal point-of-care screening and treatment program.

Overall, 310 of the 670 had already been tested for HCV status and 23.28% and 8.35% of the patients were discharged or refused, respectively, leaving 458 patients. Fifty-eight of the remaining participants had positive HCV-Ab test results and 46 had positive HCVRNA test results, all of whom underwent treatment with direct-acting antivirals and achieved 100% sustained virologic response.

At the conclusion of the study, 491 participants had HCV-Ab test results available. Of these, 69 were positive and 241 were lost to follow-up.

“We revealed a prevalence of 14.05% of HCV-Ab in conviction. Antiviral treatment was safe and efficacious. More efforts are advisable to provide screening for HCV-Ab in conviction,” they concluded.

—Michael Potts

Reference:
Masarone M, Caruso R, Aglitti A, et al. Hepatitis C virus infection in jail: Difficult-to-reach, not to-treat. Results of a point-of-care screening and treatment program [published online March 28, 2020]. Dig Liver Dis. doi: 10.1016/j.dld.2020.02.012