HCV Treatment in Prison Could Be Key Public Health Measure

Incarcerated patients as likely to receive treatment, achieve SVR as non-incarcerated

FRIDAY, Oct. 5 (HealthDay News) -- Incarcerated patients with hepatitis C virus (HCV) infection are as likely to be treated and to achieve a sustained viral response (SVR) as non-incarcerated patients, according to research published in the October issue of Hepatology.

John P. Rice, M.D., of the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues conducted a study involving 521 non-incarcerated and 388 incarcerated patients evaluated for HCV treatment at a single academic center from 2002 through 2007.

The researchers found that 61.2 percent of non-incarcerated and 60.3 percent of incarcerated patients underwent treatment with pegylated interferon and ribavirin. Patients who were incarcerated were more likely to be male, black, and have a history of alcohol or intravenous drug use; and those who were treated were less likely to have received previous treatment or to have genotype 1 virus. The prevalence of HIV co-infection was similar between the groups. An SVR was achieved in 42.9 and 38.0 percent of incarcerated and non-incarcerated patients, respectively (P = 0.304). Increased SVR was significantly associated with full treatment course, non-genotype 1 virus, younger age at start of treatment, and negative HIV status. Incarceration status was not a significant predictor of SVR.

"Anti-viral treatment of the HCV-infected incarcerated population is not only effective but can be as successful as HCV treatment in the general population," the authors write. "Given the scale of the prevalence of HCV infection in the incarcerated population, we suggest that anti-viral treatment while in prison is the optimal time for treatment to reverse a public health crisis."

One author disclosed financial ties to the pharmaceutical industry.

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