Prevalence and epidemiological correlates and treatment outcome of HCV infection in an Italian prison setting

BMC Public Health

Elena Seminari¹  Roberto Ranieri³  Savino Francesco Antonio Patruno⁴  Carmine Tinelli²  Annalisa De Silvestri²  Stefano Novati¹  Micaela Brandolini¹ 

[1] Clinica di Malattie Infettive, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy;Servizio di Biometria e Statistica, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy;Medicina Protetta Ospedale San Paolo-Milano, Milan, Italy;Divisione di Malattie Infettive e Tropicali, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy

关键词: HIV-HCV coinfection;    HCV treatment;    Prison;    HCV-prevalence;    HCV-infection;   

Others  :  1161641
DOI  :  10.1186/1471-2458-13-981

 received in 2013-05-27, accepted in 2013-10-14,  发布年份 2013

【 摘 要 】

Background

The aim of the present study is to test in the feasibility of a screening programme for HCV infection in an Italian prison and to evaluate the treatment outcomes.

Method

Single-centre cross-sectional study carried out in Milan-Opera. The HCV infection prevalence was calculated on the imprisoned population on the January 31 2006, the data on treatment over the following 2 years. Treatment option offered to HCV chronically infected patients was then analysed, reasons for not being treated was evaluated.

Results

Of the 965 inmates, 695 were enrolled in the study, 682 (98%) were males, the median age was 43 years. There were 131 (18.8%) foreigners and 564 (81.2%) Italians. HCV seroprevalence was 22.4%(95% CI:19.4%-25.7%), 60 subjects (38.4%) being HIV co-infected too. Prevalence of HCV infection was significantly higher in HIVAb positive (89.6%; 95% CI:79.7%-95.7%) than in HIVAb negative (15.15%; 95% CI 12.6%-18.3%) (p<0.001). Among Italian inmates HCVAb positivity was significantly higher than among foreigners (p=0.0154). Among HCVAb positive patients, 135 subjects were HCV-RNA positive. Forty-seven (36%) had major clinical contraindication to treatment, 18 (13%) refused the treatment, 7 (5%) moved to other Institute and 27 (20%) were not evaluated by infectious disease specialists. Fifteen patients (43%) who received treatment were considered responders, 9 (26%) were non responders/relapsers, 6 (17%) interrupted treatment due to side effects and 5 (14%) were released during treatment and lost in follow-up.

Conclusions

This study indicates that the proportion of patients in a prison setting receiving diagnosis and treatment for HCV infection remained low.

【 授权许可】

   
2013 Brandolini et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Spaulding AC, Weinbaum CM, Lau DT, Sterling R, Seeff LB, Margolis HS, Hoofnagle JH: A framework for management of hepatitis C in prisons. Ann Intern Med 2006, 144(10):762-769.
• [2]Saiz De La Hoya P, Marco A, García-Guerrero J, Rivera A: Hepatitis C and B prevalence in Spanish prisons. Eur J Clin Microbiol Infect Dis 2011, 30(7):857-862.
• [3]Babudieri S, Longo B, Sarmati L, Starnini G, Dori L, Suligoi B, Carbonara S, Monarca R, Quercia G, Florenzano G, Novati S, Sardu A, Iovinella V, Casti A, Romano A, Uccella I, Maida I, Brunetti B, Mura MS, Andreoni M, Rezza G: Correlates of HIV, HBV, and HCV infections in a prison inmate population: results from a multicentre study in Italy. J Med Virol 2005, 76(3):311-317.
• [4]Sabbatani S, Giuliani R, Fulgaro C, Paolillo P, Baldi E, Chiodo F: HIVAb, HCVAb and HBsAg seroprevalence among inmates of the prison of Bologna and the effetct of counselling on the compliance of proposed tests. Epidemiol Prev 2004, 28(3):163-168.
• [5]Decreto Ministero della Sanità: Approvazione del progetto obiettivo per la tutela della salute in ambito penitenziario. 2000. http://www.medicoeleggi.com/argomenti00/italia1/12447.htm webcite
• [6]Allen SA, Spaulding AC, Osei AM, Taylor LE, Cabral AM, Rich JD: Treatment of chronic hepatitis C in a state correctional facility. Ann Intern Med 2003, 138(3):187-190.
• [7]Maru DS, Bruce RD, Basu S, Altice FL: Clinical outcomes of hepatitis C treatment in a prison setting: feseability and effectiveness for challenging treatment populations. CID 2008, 47:952-961.
• [8]Marco A, Esteban JI, Solé C, da Silva A, Ortiz J, Roget M, Sarriera C, Teixidó N, Guerrero RA, Caylà JA: Hepatitis C virus reinfection among prisoners with sustained virological response after treatment for chronic hepatitis C. J Hepatol 2013. in press
• [9]Sabbatani S, Giuliani R, Manfredi R: Combined pegylated interferon and ribavirin for the management of chronic hepatitis C in a prison setting. Braz J Infect Dis 2006, 10(4):274-278.
• [10]Ristretti news. http://www.ristretti.it/areestudio/statistiche/ricerca_statistica/capitolo_stranieri.pdf webcite
• [11]Drug policy and harm reduction. http://ec.europa.eu/health/ph_determinants/life_style/drug/documents/drug_frep1.pdf webcite
• [12]Weinbaum C, Lyerla R, Margolis HS, Centers for Disease Control and Prevention: Prevention and control of infections with hepatitis viruses in correctional settings. MMWR Recomm Rep 2003, 52(RR-1):1-36.
• [13]Vescio MF, Longo B, Babudieri S, Starnini G, Carbonara S, Rezza G, Monarca R: Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis. J Epidemiol Community Health 2008, 62:305-313.
• [14]Larney S, Kopinski H, Beckwith CG, Zaller ND, Jarlais DD, Hagan H, Rich JD, van den Bergh BJ, Degenhardt L: The incidence and prevalence of hepatitis C in prisons and other closed settings: results of a systematic review and meta-analysis. Hepatology 2013. in press
• [15]Rantala M, van de Laar MJ: Surveillance and epidemiology of hepatitis B and C in Europe - a review. Euro Surveill 2008, 13:21.
• [16]Colbert AM, Sekula LK, Zoucha R, Cohen SM: Health care needs of women immediately post-incarceration: a mixed methods study. Public Health Nurs 2013, 30(5):409-419.
• [17]Ford N, Kirby C, Singh K, Mills EJ, Cooke G, Kamarulzaman A, duCros P: Chronic hepatitis C treatment outcomes in low- and middle-income countries: a systematic review and meta-analysis. Bull World Health Organ 2012, 90(7):540-550.
• [18]van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, Duarte-Rojo A, Heathcote EJ, Manns MP, Kuske L, Zeuzem S, Hofmann WP, de Knegt RJ, Hansen BE, Janssen HL: Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA 2012, 308(24):2584-2593.
• [19]Baillargeon J, Soloway RD, Paar D, Giordano TP, Murray O, Grady J, Williams B, Pulvino J, Raimer BG: End-stage liver disease in a state prison population. Ann Epidemiol 2007, 17(10):808-813.
• [20]Sherman KE, O’Brien J, Gutierrez AG, Harrison S, Urdea M, Neuwald P, Wilber J: Quantitative evaluation of hepatitis C virus RNA in patients with concurrent human immunodeficiency virus infection. J Clin Microbiol 1993, 31:2679-2682.
• [21]Martín-Carbonero L, Benhamou Y, Puoti M, Berenguer J, Mallolas J, Quereda C, Arizcorreta A, Gonzalez A, Rockstroh J, Asensi V, Miralles P, Laguno M, Moreno L, Girón JA, Vogel M, García-Samaniego J, Nuñez M, Romero M, Moreno S, de la Cruz JJ, Soriano V: Incidence and predictors of severe liver fibrosis in HIV infected patients with chronic hepatitis C: European Collaborative Study. Clin Infect Dis 2004, 38:128-133.
• [22]Seminari E, Tinelli C, Ravasi G, Ripamonti D, Ladisa N, Marino N, Sighinolfi L, Mondello P, Migliorino M, Carosi G, Maserati R: Hepatitis C infection on immune recovery in HIV-positive patients on successful HAART: the role of genotype 3. Curr HIV Res 2010, 8(3):186-193.
• [23]Baillargeon JG, Paar DP, Wu H, Giordano TP, Murray O, Raimer BG, Avery EN, Diamond PM, Pulvino JS: Psychiatric disorders, HIV infection and HIV/hepatitis co-infection in the correctional setting. AIDS Care 2008, 20(1):124-129.
• [24]Farley J, Vasdev S, Fischer B, Haydon E, Rehm J, Farley TA: Feasibility and outcome of HCV treatment in a Canadian federal prison population. Am J Public Health 2005, 95(10):1737-1739.