AN INTERVENTION TO INCREASE HEPATITIS C VIRUS DIAGNOSIS AND TREATMENT UPTAKE AMONG PEOPLE IN CUSTODY IN IRAN

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 598

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شناسه ملی سند علمی:

KAMED13_294

تاریخ نمایه سازی: 10 دی 1398

چکیده مقاله:

Background and Aim : Hepatitis C virus (HCV) diagnosis and treatment is sub-optimal in prisons. The aim of this study was to evaluate the impact of an innovative intervention on HCV diagnosis and treatment uptake in a large provincial prison in Northern Iran.Methods : Between July and December 2018, in the central prison of Gorgan, all inmates received HCV antibody testing and venepuncture for HCV RNA testing (HCV antibody positive only). AST to Platelet Ratio Index (APRI) was used for liver disease assessment. People with HCV infection received direct-acting antiviral (DAA) therapy (sofosbuvir/daclatasvir). Response to therapy was measured by sustained virological response (SVR), defined as undetectable HCV RNA 12 weeks post-treatment (SVR12). If released during or after DAA therapy, participants were referred to the local health network for treatment completion and SVR 12 evaluation.Results : Among 1,482 prison residents, 95% were male, the median age was 35 (IQR: 29-41 = 12 years), 72% had a history of drug use, and 37% had used drugs in the previous year. Prevalence of HCV antibody and HCV RNA were 7.5% (n=111) and 5.7% (n=84), respectively. Among participants with HCV infection, 81% (n=68) initiated DAA therapy and 19% (n=16) were released before treatment initiation. Among those who initiated treatment, 76% (n=52) completed their DAA course in prison and 24% (n=16) were released during antiviral therapy. SVR 12 was 100% among participants who completed HCV treatment in prison, including n=10 who had used drugs in the previous year. SVR 12 could not be measured among participants who were released prior to treatment completion, given the provision of incorrect contact information.Conclusion : In a provincial prison with no history of HCV testing and treatment, treatment uptake was remarkably high, highlighting the feasibility of HCV treatment programs in custodial settings. Ongoing efforts are needed to expand HCV diagnosis and treatment in Iranian prisons and optimize post-release engagement with care.

نویسندگان

Hossein Poustchi

Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Maryam Alavi

Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Sanam Hariri

Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Gholamreza Roshandel

Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran

Zahra Mohammadi

Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Abdolreza Fazel

Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran