Treatment Outcomes With Pegylated Interferon and Ribavirin for Male Prisoners With Chronic Hepatitis C

Chew, Kara W.; Allen, Scott; Taylor, Lynn E.; Rich, Josiah D.; Feller, Edward

doi:10.1097/mcg.0b013e31818dd94c

Cited by 38 publications

(31 citation statements)

References 25 publications

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“…SVR rates in prisoners infected with genotype 1 varied between 18% and 43.1%, while those in prisoners infected with genotype 3 were in the range from 50% to 71.4% (3,24,25,26). In the present study, SVR rates at 6 months post-treatment were 75% for all genotypes.…”

Section: Discussionsupporting

confidence: 51%

Hepatitis C Prevalence and Responses to Pegylated Interferon + Ribavirin Treatment Among Prisoners

Özger¹,

Karaşahin²,

Toy³

et al. 2017

vhd

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ÖZObjective: The aim of our study was to identify the hepatitis C prevalence in prisoners and to share experiences of pegylated interferon (peg-IFN) + ribavirin (RBV) treatment. Materials and Methods:The study was conducted by assessing the records of prisoners between January 2014 and 2016, retrospectively. Patients in whom planned treatments were applied in a given time were determined and, virologic responses at the end of treatment and 6 months after treatment were evaluated. Chi-square test was used and a p value of less than 0.05 was considered statistically significant. Results: Among prisoners, the anti-hepatitis C virus (HCV) positivity rate was 7.82% and HCV-RNA positivity rate was 5.72%. The most common genotype was genotype 3a (66 of 99 patients).End-of-treatment and 6 th month sustained virologic response rates were 84.6% and 80.5%, respectively. In genotype 3a group, endof-treatment and 6 th month sustained virologic response rates were found to be higher than other genotypes but not statistically significant. Conclusion:In our study, which assessed prisoners, the rate of HCV positivity was higher than hepatitis C in the general population in Turkey. In accordance with the literature, genotype 3 was the most common genotype among prisoners. Sustained virologic response rates obtained with peg-IFN+RBV treatment suggested that peg-IFN treatment should be used with current treatment combinations in prisoners infected with HCV genotype 3. Keywords: Hepatitis C, prisoner, prevalence, pegylated interferon + ribavirin Amaç: Çalışmamızın amacı mahkumlardaki hepatit C prevalansını belirlemek ve pegile interferon (peg-IFN) + ribavirin (RBV) tedavi deneyimlerini paylaşmaktır. Gereç ve Yöntemler: Çalışma, Ocak 2014 ve 2016 yılları arasında mahkum kayıtlarını retrospektif olarak değerlendirilerek gerçekleştirildi. Belirlenen sürede planlanan tedavilerin uygulanabildiği hastalar tespit edildi, tedavi sonu ve sonraki 6. ay virolojik yanıtları değerlendirildi. Ki-kare testi kullanıldı ve p<0,05 istatistiksel anlamlılık düzeyi olarak kabul edildi. Bulgular: Mahkumlarda, anti-hepatit C virüsü (HCV) pozitifliği %7,82 ve HCV-RNA pozitifliği %5,72 idi. En yaygın genotip 3a genotipi (99 hastanın 66'sı) idi. Tedavi sonu ve 6. ayda devam eden virolojik yanıt oranları sırasıyla %84,6 ve %80,5 idi. Genotip 3a grubunda, tedavi sonu ve 6. ayda devam eden virolojik yanıt oranları diğer genotiplerden daha yüksek bulundu ancak istatistiksel olarak anlamlı değildi. Sonuç: Mahkumları değerlendiren çalışmamızda HCV pozitifliği, genel olarak Türkiye'deki pozitifliğe göre daha yüksek bulunmuştur. Literatürle benzer olarak, mahkumlarda genotip 3 en yaygın genotip olarak tespit edilmiştir. Peg-IFN+RBV tedavisi ile elde edilen virolojik yanıt oranları, peg-IFN tedavisinin, HCV genotip 3 ile enfekte mahkumlardaki mevcut tedavi kombinasyonları içerisinde yer alması gerektiğini düşündürmektedir.

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Section: Discussionsupporting

confidence: 51%

Hepatitis C Prevalence and Responses to Pegylated Interferon + Ribavirin Treatment Among Prisoners

Özger¹,

Karaşahin²,

Toy³

et al. 2017

vhd

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“…Efficacy and safety of HCV treatment has been described among prison inmates in both the Rhode Island and Connecticut Departments of Corrections [34,35]. Treatment with pegylated interferon and ribavirin resulted in overall SVR rates of 43%, and 47% respectively, comparable to that of the general population.…”

Section: Prison Inmatesmentioning

confidence: 85%

HCV In At Risk Populations: Who Can be Treated and How?

Martinez

Gish

2012

Curr Hepatitis Rep

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Hepatitis C virus (HCV), a major cause of chronic liver disease, affects an estimated 5 million people in the Unites States [1] and close to 170 million people worldwide. Certain subpopulations including injection drug users, prison inmates, the homeless, ethnic minorities, American veterans, and HIV co-infected patients are considered high risk for viral acquisition and are disproportionately affected by HCV. This review describes the prevalence of HCV in these at-risk populations including those with cirrhosis, chronic kidney disease (CKD), solid organ transplantation and presents current treatment options.

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“…14 Specific to the RIDOC population, studies have reported HCV prevalence rates from 23 to 27 %. 12,25,40,41 We conducted a cross-sectional survey of all incarcerations at RIDOC as of February 2014 and reviewed the electronic medical records (EMR) for data on screening uptake and clinical characteristics (see Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…We selected the total drug costs of treating all 24,25 To capture hypothetical market pricing of newly available and upcoming therapies, we projected costs given either 25 or 50 % reduction or an increase by 25 or 50 % based on current total medication costs. To further account for incarceration periods, we assessed treating those with a remaining length of stay of at least 3 months, at least 9 and 12 months or more.…”

Section: Methodsmentioning

confidence: 99%

“…23 Although treatment uptake in correctional settings was limited, successful treatment initiatives have been described. [24][25][26][27] In November and December of 2013, the US Food and Drug Administration (FDA) approved simeprevir (SMV) and sofosbuvir (SOF) for the treatment of chronic HCV, and combination use of these two drugs introduced a shorter, off-label interferon-free regimen for all genotypes with sustained virologic rates (SVRs) greater than 70 %. SVRs as high as 97 % were achieved in genotype 2 patients with SOF+RBV combination therapy.…”

Section: Introductionmentioning

confidence: 99%

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A Budget Impact Analysis of Newly Available Hepatitis C Therapeutics and the Financial Burden on a State Correctional System

et al. 2015

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Hepatitis C virus (HCV) infection continues to disproportionately affect incarcerated populations. New HCV drugs present opportunities and challenges to address HCVin corrections. The goal of this study was to evaluate the impact of the treatment costs for HCV infection in a state correctional population through a budget impact analysis comparing differing treatment strategies. Electronic and paper medical records were reviewed to estimate the prevalence of hepatitis C within the Rhode Island Department of Corrections. Three treatment strategies were evaluated as follows: (1) treating all chronically infected persons, (2) treating only patients with demonstrated fibrosis, and (3) treating only patients with advanced fibrosis. Budget impact was computed as the percentage of pharmacy and overall healthcare expenditures accrued by total drug costs assuming entirely interferon-free therapy. Sensitivity analyses assessed potential variance in costs related to variability in HCV prevalence, genotype, estimated variation in market pricing, length of stay for the sentenced population, and uptake of newly available regimens. Chronic HCV prevalence was estimated at 17 % of the total population. Treating all sentenced inmates with at least 6 months remaining of their sentence would cost about $34 million-13 times the pharmacy budget and almost twice the overall healthcare budget. Treating inmates with advanced fibrosis would cost about $15 million. A hypothetical 50 % reduction in total drug costs for future therapies could cost $17 million to treat all eligible inmates. With immense costs projected with new treatment, it is unlikely that correctional facilities will have the capacity to treat all those afflicted with HCV. Alternative payment strategies in collaboration with outside programs may be necessary to curb this epidemic. In order to improve care and treatment delivery, drug costs also need to be seriously reevaluated to be more accessible and equitable now that HCV is more curable.

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Treatment Outcomes With Pegylated Interferon and Ribavirin for Male Prisoners With Chronic Hepatitis C

Cited by 38 publications

References 25 publications

Hepatitis C Prevalence and Responses to Pegylated Interferon + Ribavirin Treatment Among Prisoners

Hepatitis C Prevalence and Responses to Pegylated Interferon + Ribavirin Treatment Among Prisoners

HCV In At Risk Populations: Who Can be Treated and How?

A Budget Impact Analysis of Newly Available Hepatitis C Therapeutics and the Financial Burden on a State Correctional System

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