消除监狱中的丙型肝炎病毒:18 年的经验

Maite Nogales-Garcia , Naiara Parraza Diez , Andoni Vargas Axpe , Rafael Velasco Garcia , Ane Larrabeiti-Etxebarria , Ignacio Roy Lopez-Cano , Inmaculada Atrio Alvarez , Asier Lopez de Arcaute Trincado , Eva María Fernandez Lopez de Vicuña , Ester Saez de Adana Arroniz , Carlos Martínez Martínez , Joseba Portu Zapirain
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摘要

导言尽管近年来西班牙监狱中丙型肝炎的发病率有所下降,但它仍然是一个传染源。本研究旨在分析这些患者的特征以及过去 18 年中对抗病毒治疗的反应。方法对 2002 年至 2020 年期间在阿拉巴监狱中心确诊感染 HCV 的囚犯进行回顾性观察研究。对患者特征和三种抗病毒治疗方式的反应进行了描述性分析:聚干扰素和利巴韦林,聚干扰素、利巴韦林和第一代蛋白酶抑制剂,以及直接作用抗病毒药物的不同组合。2015年之前的治疗应答率为65%,2015年之后为93.7%。干扰素无效者是第一和第二阶段治疗无效的主要原因(40%-50%)。结论18 年后,根据临床标准,监狱囚犯中的活动性丙型肝炎感染经治疗后已得到缓解。因此,在狱中服刑可能是减少社区中丙型肝炎病毒库的一个机会,同时也是为刑满释放人员提供持续医疗保健的一个机会。
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Elimination of hepatitis C virus in a prison: An 18-year experience

Introduction

Despite the decrease of hepatitis C in Spanish prisons in the last years, it still remains a reservoir for infection. The aim of this work is to analyze the characteristics of these patients and the response to antiviral treatment over the last 18 years.

Methods

Retrospective observational study in inmates of Araba penitentiary center diagnosed with HCV infection between 2002 and 2020.

A descriptive analysis of patient characteristics and the response to the three antiviral treatment modalities was performed: peg-interferon and ribavirin, peg-interferon, ribavirin and a first-generation protease inhibitor and different combinations of direct-acting antivirals.

Results

A total of 248 antiviral treatments were prescribed. Treatment response rate up to 2015 was 65% and 93,7% after that year. Interferon non-responders were the main cause of non-response to treatment in periods 1 and 2 (40%–50%). Conversely, in period 3 viral breakthrough (67%) was the main culprit.

Conclusion

After 18 years, active hepatitis C infection in prison inmates has resolved with treatment according to clinical criteria. Therefore, the stay in prison may represent an opportunity to reduce the reservoir of the disease in the community, together with continued health care for those released from prison.

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