Background and importance The prevalence of patients with hepatitis C virus (HCV) viral load in national prisons was 3% in 2018, 2.5 times lower than the one obtained 10 years ago. In fact, since patients started to be treated with interferon-free-based treatments in 2015, a drastic decrease in HCV viral load prevalence was observed.
Aim and objectives To evaluate the response to treatment in inmates of a prison presenting HIV-HCV co-infection and that following treatment with HCV antiviral drugs.
Material and methods A descriptive observational study was conducted. The electronic clinical history and prescriptions of patients receiving HCV antivirals between 1 November 2002 and 31 December 2020 were reviewed. Moreover, the following data were collected: age, gender, HIV serology, discontinuation or not of the treatment and sustained viral response (SVR) at 12–24 weeks after treatment end. This response was defined as undetectable HCV-RNA 12–24 weeks after treatment compliance. The role of the pharmacist was adherence and adverse effects monitoring and to undertake an educational work.
Results During the study 251 patients were treated, of which 33.4% were co-infected with HIV-HCV. Their average age was 43 years and 86.9% were males.
From 2002 to 2014, 33% of the 127 patients treated with interferon-based regimens were co-infected, and 50% of them obtained SVR, in contrast with mono-infected individuals, of whom 70.5% obtained SVR. Moreover, 28.5% co-infected patients did not respond to the treatment, 9.5% discontinued, 7.1% relapsed, 2.3% abandoned treatment because of intolerance and 2.3% were moved to another prison.
However, between 2015 and 2020, from the 34.4% co-infected patients (from a total of 125) treated with interferon-free regimens (DDA), 95.2% obtained a SVR, meanwhile 92.5% of the mono-infected individuals obtained SVR. One of the co-infected patients relapsed and another obtained a response of breakthrough.
Conclusion and relevance The efficacy of antivirals in co-infected patients has increased due to the implementation of improved treatment guidelines, reaching more than 95% SVR with DDA, which approximates to the rates in the rest of the population. Treatment access for all patients and high treatment efficacy has led to 0% prevalence in this prison.
References and/or acknowledgements 1. Prevalencia de las infecciones VIH y VHC en Instituciones Penitenciarias 2018. Secretaria General de Instituciones Penitenciarias. Subdirección General de Coordinación de Sanidad Penitenciaria, 2018. Ministerio del Interior.
Conflict of interest No conflict of interest
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