Solving the Gap Between HCV Detection and Treatment in Prison HCVRNA Testing and Treatment in a Cohort of Newly Arrived Convicts in Southern Italy

Title:Solving the Gap Between HCV Detection and Treatment in Prison HCVRNA Testing and Treatment in a Cohort of Newly Arrived Convicts in Southern Italy

Volume: 16 Issue: 4

Author(s): Carmine Izzo*, Mario Masarone, Pietro Torre , Giuseppe Melara , Giuseppe De Matteis , Antonio De Luna, Antonio Maria Pagano and Marcello Persico *

Affiliation:

• Internal Medicine and Hepatology Division, Department of Medicine and Surgery Scuola Medica Salernitana , Salerno,Italy

• Internal Medicine and Hepatology Division, Department of Medicine and Surgery Scuola Medica Salernitana , Salerno, Italy

Keywords: Direct antiviral agents, HCV infection, people in conviction, point-of-care, HCV treatment, sustained virologicalresponse.

Abstract: Introduction: HCV infection elimination is set to be carried out by 2030. To achieve this goal, the WHO has set minor achievable short-term “mini-goals.” One of these is treating “difficult to reach and treat populations,” such as prisoners. One of the biggest obstacles to achieving this mini goal is the poor knowledge of the real HCV prevalence in such a population and the barriers to its detection, treatment, and follow-up. Even if HCV testing in Italian prisons is feasible and recommended, it is not however always carried out. To worsen the picture, the peculiar status of conviction is correlated to difficulty in caring out the antiviral therapy due to loss in follow-up and to the refusals by inmates.

Aims: A point-of-care test-and-treat program was set up in a penitentiary in Southern Italy to reduce the number of patients Lost To Follow-Up (LTFU) between detection and treatment. A secondary aim was to evaluate the prevalence of HCV-infected patients in a cohort of newly arrived inmates.

Methods: This prospective-observational study was carried out from January 2020 to February 2020. We performed an HCV-RNA blood capillary quick test on all newly arrived inmates. As a routine, the new inmates underwent clinical and laboratory assessments. To those who were detected HCV-RNA positive, the shortest possible antiviral treatment was offered, according to genotype and clinical features.

Results: We observed 122 new inmates in the period between January and February of 2020. Overall, 62 (50.8%) subjects took HCV-RNA quick testing through blood sampling. Four (6.4%) subjects were found to be HCV-RNA positive; 1 refused antiviral therapy, while 3 accepted, obtaining 100% SVR. None of the HCV-active inmates were lost to follow up between detection and treatment proposal.

Conclusion: The use of a high-speed test-and-treat protocol for HCV infection was demonstrated to be effective in avoiding LTFU in HCV-positive new inmates in the period between detection and treatment. We observed an apparent prevalence of HCV incident cases in newly arrived inmates of 6.4%. Antiviral therapy was quickly provided and found to be effective and successful.

Cite this article as:

Izzo Carmine *, Masarone Mario , Torre Pietro , Melara Giuseppe, De Matteis Giuseppe, De Luna Antonio , Pagano Maria Antonio and Persico Marcello*, Solving the Gap Between HCV Detection and Treatment in Prison HCVRNA Testing and Treatment in a Cohort of Newly Arrived Convicts in Southern Italy, Reviews on Recent Clinical Trials 2021; 16 (4) . https://dx.doi.org/10.2174/1574887116666210612033824