Differences in HCV Seroprevalence, Clinical Features, and Treatment Outcomes between Female and Male Incarcerated Population: Results from a Matched Cohort Study

Abstract

Background: Women represent less than 5% of the incarcerated population in Italy, with very limited data on HCV infection. Higher HCV seroprevalence and active infection rates have been described among incarcerated females in available studies. Our aim is to compare the prevalence and cascade of care of HCV between male and female populations in Italian penitentiaries. Methods: We conducted a multicentre, retrospective study comparing HCV seroprevalence, active infections, treatment, and SVR rates between female (Group A) and male (Group B) populations in Italian prison settings. Results: No significant differences were found between the two groups regarding PWIDs (p = 0.16), nor in people living with HIV (p = 0.35) or HBV co-infection (p = 0.36). HCV seroprevalence was higher in Group A (p = 0.002). There was no statistically significant difference between the two groups regarding active infections (p = 0.41). Both groups showed a low level of fibrosis, and the dominant genotype was 3a. Almost all patients underwent antiviral treatment. All treated patients achieved SVR12. Conclusions: Our findings illuminate the importance of recognizing and addressing gender differences in HCV seroprevalence within penitentiary settings. Moving forward, addressing the unique needs of incarcerated females and optimizing HCV care for all incarcerated individuals are essential steps in the pursuit of achieving HCV micro-elimination goals.

HBV in Italian Women’s Jail: An Underestimated Problem?

“…Prisons and jails are potential reservoirs of viral hepatitis due to higher rates of blood-borne infection (BBI) among detainees, including HBV, HCV, and HIV [ 20 , 21 ]. This increased risk is attributed to the concentration of marginalized people, such as people who inject drugs (PWID) and people who exchange sex for drugs, or sex workers [ 21 , 22 , 23 ]. A high prevalence of parenterally and sexually transmitted infections was found among inmates of Italian prisons [ 24 ].…”

“…Regarding HBV infections and the seroprevalence of anti-HBs protective titers in incarcerated women, the data suggest similarities to the male incarcerated population, with high rates of HBV susceptibility to infection individuals [ 35 ]. To our knowledge, available national HBV data about females in detention are scarce, and extrapolating information is challenging due to the relatively low proportion of women in Italian prisons (range 2.1–6.9%) [ 21 ].…”