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HCV Management in the Incarcerated Population: How Do We Deliver on This Important Front?

  • Hepatitis C (H Vargas and S Flamm, Section Editors)
  • Published:
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Abstract

Purpose of Review

In this review, the peculiarities of infection and treatment of HCV in the prison population are detailed. In addition, the barriers to HCV treatment and possible solutions are highlighted.

Recent Findings

Several previous experiences of HCV treatment in prisons have been successful. In this manuscript, we detail the most relevant.

Summary

We think that incarceration should be considered an opportunity to engage this population in health care. Therefore, we should encourage systematic screening of these patients and promote the access to treatment by supporting equity with the general population. Thus, inmates’ care must involve a multidisciplinary team. To solve this matter, we propose telehealth to bring together all these services and overcome the geographical barrier(s) and improve costs. Then, to go further in hepatitis C elimination, harm-reduction programs should be added to treat with direct-acting antivirals.

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Abbreviations

HCV:

Hepatitis C virus

PWID:

People who injects drugs

HBV:

Hepatitis B virus

HIV:

Human immunodeficiency virus

DAA:

Direct-acting antiviral

HRP:

Harm-reduction program

SVR:

Sustained viral response

OST:

Opioid substitution therapy

NSP:

Needle-syringe programs

DOT:

Direct observed therapy

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Funding

We thank the support from the excellence grant titled “Proyecto Integrado de Excelencia” (PIE15/00079) and Endothelial Dysfunction in Patients with HCV Infection, Characterization and Potential Reversal with Direct-Acting Antivirals (PI15/02138). We also thank the support from the unrestricted grant given by Gilead Sciences.

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Authors and Affiliations

  1. Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Research Institute Valdecilla (IDIVAL in Spanish), School of Medicine, University of Cantabria, Avda. de Valdecilla s/n, 39008, Santander, Cantabria, Spain

    Javier Crespo, Susana Llerena, Joaquin Cabezas & Antonio Cuadrado

  2. Medical Service, Penitentiary Center “El Dueso”, Santoña, Spain

    Carmen Cobo

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  1. Javier Crespo
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  2. Susana Llerena
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  3. Carmen Cobo
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  5. Antonio Cuadrado
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Correspondence to Javier Crespo.

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Gilead Sciences did not participate in the design, data analysis, and manuscript preparation.

Conflict of Interest

Susana Llerena, Carmen Cobo, Joaquin Cabezas, and Antonio Cuadrado each declare no potential conflicts of interest. Javier Crespo reports grants and personal fees from Gilead, grants and personal fees from AbbVie, grants and personal fees from MSD, and personal fees from Janssen, during the conduct of the study.

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Crespo, J., Llerena, S., Cobo, C. et al. HCV Management in the Incarcerated Population: How Do We Deliver on This Important Front?. Curr Hepatology Rep 18, 259–267 (2019). https://doi.org/10.1007/s11901-019-00472-2

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