- HCV treatment with direct-acting antivirals (DAAs) is feasible and effective in Italian penitentiary settings, where infection rates are estimated to range from 22.8%-38%.
Why this matters
- High prevalence and risky behaviors render prisons an HCV reservoir for the entire community.
- Since 2015, European Association for the Study of Liver Disease (EASL) guidelines have emphasized the importance of treating incarcerated individuals.
- Study of 142 HCV-infected people incarcerated in 25 Italian prisons during May 2015 to October 2016, receiving sofosbuvir-based regimens.
- Primary endpoint was sustained virologic response at 12 weeks posttherapy (SVR12).
- Funding: None.
- Majority of patients were male (98.6%) of Italian nationality (93.7%); mean age was 50±7.5 years.
- Cirrhosis was highly prevalent (76.1%), as were HCV genotypes 1a (35.9%) and 3 (35.9%).
- 84% of infections were among intravenous drug users (IDU), of whom 38.6% were receiving opioid substitution therapy (OST).
- 14.8% of patients were coinfected with HIV, of whom 95.2% received antiretroviral therapy.
- Completion rate was 94.4%; 6 of 8 discontinuations were associated with prison release.
- SVR12 was 90.8% (virologic failures, 3.5%; loss to follow-up, 5.6%).
- SVR12 was high in patients with cirrhosis (90.7%), and among IDU (98.3%) and IDU on OST (97.8%).
- Homogenous population.