Chronic Hepatitis C Cascade of Care in Prisoners—Is There Still Some Work to Do? Analysis of Two Large Penitentiaries in Northern Italy

Anna Cambianica (), Valentina Marchese, Francesca Pennati, Alessandro Faustinelli, Manuela Migliorati, Fabio Roda, Angiola Spinetti, Serena Zaltron, Simona Fiorentini, Arnaldo Caruso, Eugenia Quiros-Roldan, Francesco Castelli and Emanuele Focà
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Anna Cambianica: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy
Valentina Marchese: Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy
Francesca Pennati: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy
Alessandro Faustinelli: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy
Manuela Migliorati: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy
Fabio Roda: Unit of Prison Health, ASST Spedali Civili Hospital, 25123 Brescia, Italy
Angiola Spinetti: Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy
Serena Zaltron: Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy
Simona Fiorentini: Unit of Microbiology and Virology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
Arnaldo Caruso: Unit of Microbiology and Virology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
Eugenia Quiros-Roldan: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy
Francesco Castelli: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy
Emanuele Focà: Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy

IJERPH, 2024, vol. 21, issue 1, 1-11

Abstract: Penitentiaries have a higher burden of communicable diseases compared to the general population. Prisoners should be tested for hepatitis C virus (HCV) and have direct access to treatment. We analysed the HCV cascade of care in two penitentiaries in Brescia, Northern Italy. At admission, prisoners are offered a voluntary screening for HCV, while patients with known infections are tested with an HCVRNA measurement. We performed an observational retrospective study including all the subjects admitted to the penitentiaries from 1 January 2015 to 31 October 2021. We conducted a descriptive analysis. During the study period, 5378 admissions were registered, and 2932 (54.5%) screenings were performed. Hepatitis C virus antibody positivity was found in 269 tests (9.2%). Hepatitis C virus RNA was detectable in 169 people. During the study period, 77 treatments with direct-acting antivirals (DAAs) were administered. Follow-up was available in 45 patients, and sustained virological response (SVR) was documented in 44 of them. Retention in care occurred in less than half of the prisoners after release. Our data demonstrate poor screening adherence that could benefit from educational programs. Treatment rates could be improved with test-and-treat programs. More efforts are needed to eliminate HCV as a public threat by 2030. Dedicated local networks, including infectious diseases (ID) departments, substance abuse services and prisons, could mitigate these issues.

Keywords: hepatitis C; HCV; direct-acting antivirals; DAA; prison; inmates; screening (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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