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Management of HCV infection in the penitentiary setting in the direct-acting antivirals era: practical recommendations from an expert panel

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An Erratum to this article was published on 08 February 2017

Abstract

Background

The prevalence of HCV infection is higher among prisoners than in the general population. The introduction of HCV direct-acting antivirals (DAA) holds the potential to improve clinical outcomes also in inmates. However, treatment of hepatitis C in inmates has to face several clinical and logistical issues which are peculiar of prison environment. Recommendations on the management of HCV infection specific for the penitentiary setting in the DAA era remain scant. The Italian Society for Penitentiary Medicine and Healthcare has, therefore, issued these recommendations, to provide clinicians with a guide for the comprehensive management of HCV infection in the restriction setting, taking into account its peculiar characteristics.

Results

Dedicated diagnostic and treatment procedures should be established in each prison. In particular, the use of DAAs appears crucial to provide patients with an effective therapeutic option, able to overcome the limitations of IFN-based regimens with a short period of treatment. DAA treatment should be initiated as soon as possible in all eligible subjects with the aim to cure the patient, as well as to limit the transmission of HCV infection both inside the penitentiary system and to the free community, once the inmates ends his/her release. Importantly, efforts should be made to open a discussion with regulatory bodies, to define specific regulations aimed to guarantee wide access to effective therapies of all eligible patients, to optimize the management of and the adherence to the HCV treatment, and to ensure the therapeutic continuity after discharge from prison.

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Acknowledgements

Editorial assistance for the preparation of this manuscript was provided by Luca Giacomelli, PhD; this assistance was supported by an unrestricted grant by Abbvie.

Author information

Authors and Affiliations

  1. Azienda Ospedaliera Santi Paolo e Carlo Penitentiary Infectious Diseases Unit, University of Milan, Milan, Italy

    Roberto Ranieri

  2. SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy

    Roberto Ranieri, Giulio Starnini, Sergio Carbonara, Emanuele Pontali, Guido Leo, Roberto Monarca & Sergio Babudieri

  3. U.O.C. Medicina protetta-Malattie infettive, Viterbo, Italy

    Giulio Starnini

  4. Clinic of Infectious Diseases, University of Bari, Bari, Italy

    Sergio Carbonara

  5. Infectious Disease Unit, Ospedale Galliera, Genoa, Italy

    Emanuele Pontali

  6. Infectious Disease Unit, Ospedale Amedeo di Savoia, Turin, Italy

    Guido Leo

  7. Cisanello Hospital, Pisa, Italy

    Antonio Romano

  8. Ospedale dell’Angelo Malattie infettive e Tropicali, Venice, Italy

    Sandro Panese

  9. Ospedale Belcolle, Viterbo, Italy

    Roberto Monarca

  10. ARNAS, Ospedale Civico-Benfratelli Palermo, Palermo, Italy

    Tullio Prestileo

  11. Malattie Infettive e Tropicali IRCCS San Matteo, Università di Pavia, Pavia, Italy

    Giorgio Barbarini

  12. Case Circondariali di Pavia, Voghera e Vigevano, Italy

    Giorgio Barbarini

  13. Infectious Disease Unit, University of Sassari, Sassari, Italy

    Sergio Babudieri

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  1. Roberto Ranieri
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Consortia

on behalf of the SIMSPe Group

  • Beate Koeler
  • , Maddalena Casana
  • , Renato Dalle Nogare
  • , Serena Dell’Isola
  • , Francesco Di Lorenzo
  • , Claudia Fabrizio
  • , Antonella Foschi
  • , Maria Giuliano
  • , Anna lalungo
  • , Luciano Lucania
  • , Giordano Madeddu
  • , Michela Melis
  • , Oscar Mollaretti
  • , Alberto Muredda
  • , Elena Rastrelli
  •  & Fabio Signorile

Corresponding author

Correspondence to Sergio Babudieri.

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Conflict of interest

None relevant.

Additional information

The original version of this article was revised: the given names and family names of all authors were transposed.

Members of the SIMSPe Group are listed in Appendix.

An erratum to this article is available at http://dx.doi.org/10.1007/s15010-017-0983-6.

Appendix

Appendix

Members of the SIMSPe Group: Beate Koeler, Viterbo; Maddalena Casana, Milano; Renato Dalle Nogare, Palermo; Serena Dell’Isola, Viterbo; Francesco Di Lorenzo, Palermo; Claudia Fabrizio, Bari; Antonella Foschi, Milano; Maria Giuliano, Torino; Anna Ialungo, Viterbo; Luciano Lucania, Reggio Calabria; Giordano Madeddu, Sassari; Michela Melis, Sassari; Oscar Mollaretti, Torino; Alberto Muredda, Sassari; Elena Rastrelli, Viterbo; and Fabio Signorile, Bari.

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Ranieri, R., Starnini, G., Carbonara, S. et al. Management of HCV infection in the penitentiary setting in the direct-acting antivirals era: practical recommendations from an expert panel. Infection 45, 131–138 (2017). https://doi.org/10.1007/s15010-016-0973-0

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