Prisoners Treated for Hepatitis C with Protease Inhibitor, New York, USA, 2012

Autor: Anne C. Spaulding, Carl Koenigsmann, Min Jung Kim, Harish Moorjani
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Emerging Infectious Diseases, Vol 21, Iss 1, Pp 186-188 (2015)
Emerging Infectious Diseases
ISSN: 1080-6059
1080-6040
Popis: To the Editor: Globally, epidemics of infection with hepatitis C virus (HCV) tend to be concentrated in correctional facilities, according to a review of worldwide literature during 1990–2012 (1,2). Nearly 1 in 3 persons infected with HCV in the United States spends at least part of each year in either a prison or jail (3). Proficiency by correctional health facilities in hepatitis C treatment by using the most effective agents may mitigate the predicted burden of end-stage liver disease and hepatocellular cancer in the coming years. The first wave of direct-acting agents against HCV had substantial side effects. Nonetheless, the New York Department of Corrections and Community Supervision (NYDOCCS) systematically approached the challenge of using these agents, and their experience serves as a lesson that prison medical services can overcome substantial barriers to care. In 2011, NYDOCCS piloted a hepatitis C treatment program for HCV genotypes 1a and 1b, comprised of telaprevir, pegylated interferon, and ribavirin. Patients underwent extensive mandatory pretreatment screening for mental health issues, pregnancy, and cirrhosis by using the FibroSURE assay (LabCorp, Burlington, NC, USA) and Doppler sonogram of the portal vein. Eligibility requirements were a negative HIV test result, and liver fibrosis assessed either by liver biopsy or noninvasively, at METAVIR stage 2 or 3, or 4 (reference range 0–6) (4) with compensation. A patient in stage 1 was eligible if the patient had poor prognostic factors. An infectious disease consultant saw every patient; each patient received mandatory patient education. Mandatory conditions for patients participating in the program were to sign a consent form agreeing to the medication, participate in laboratory monitoring, and attend primary or specialty clinic follow-up appointments; 3 refusals of any program component in any combination would result in medication discontinuation. Because referring physicians conducted the initial screening of potential participants, the exact number of patients screened cannot be determined. The most frequent factor for ineligibility was uncontrolled psychiatric disease. Facilities were encouraged to treat
Databáze: OpenAIRE
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