Vito Fiore1, Giuseppe De Matteis2, Roberto Ranieri3, Laura Saderi4, Emanuele Pontali5, Alberto Muredda6, Anna Maria Ialungo7, Rosa Caruso2, Giordano Madeddu1, Giovanni Sotgiu4, Sergio Babudieri8. 1. Infectious and Tropical Disease Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. 2. Health protection for adults and youth Unit, Penitentiary Institute, Salerno, Italy. 3. Penitentiary Infectious Diseases Unit, A.O. Santi Paolo e Carlo, University of Milan, Milan, Italy. 4. Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. 5. Infectious Disease Unit, Galliera Hospital, Genoa, Italy. 6. Healthcare Area Penitentiary Institute of Alghero, Sassari, Italy. 7. Medicina Protetta-Unit of Infectious Diseases, Belcolle Hospital, Viterbo, Italy. 8. Infectious and Tropical Disease Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Healthcare Area Penitentiary Institute of Bancali, Sassari, Italy. Electronic address: babuder@uniss.it.
Abstract
BACKGROUND: HCV infection among vulnerable populations is currently a major issue for HCV elimination program. Incarcerated people and people who inject drugs (PWIDs) are key population groups potentially at high risk for HCV infection. Our aim was to evaluate an extended program of screening, staging and treatment in Italian prison settings. METHODS: Patients from eight prisons in five different Italian Regions were enrolled. HCV saliva test (QuickOral Test®) was offered. Data on infection awareness and illicit drug use were also collected. Positive patients underwent early HCV RNA evaluation, staging and prescription on DAAs treatment. The definition of PWID was based on self-reported injecting drug use extracted from medical records (injecting drug use during the previous six months). RESULTS: A total of 2,376 out of 2,687 individuals (88%) was tested. The median (IQR) age was 42 (32-50) years. PWIDs were 537out of 2,376 (23%). Prevalence of HCV antibodies was 10.4% (248/2,376). PWIDs had a lower awareness of their HCV-Ab positivity than non-PWIDs (p-value <0.001). Furthermore, PWIDs were less likely to be previously treated than non-PWIDs (78% vs 96%, p-value= 0.017). Active infection was found in 41% of patients (101/248). Overall, 61% HCV-positive were PWIDs, with 44% HCV RNA positive. HCV therapy was prescribed to 83% (84/101) of patients with active HCV infection and 67% of these (56/84) were PWIDs. Prescription for HCV treatment in PWIDs accounted for 84% (56/67) (while for non-PWIDs was 82% (28/34) p-value: 0.88. Seventeen patients were referred to a Specialist in other prisons because they were going to be transferred soon to another prison. EOT, as well as SVR12 were achieved in 98% (82/84) treated patients. CONCLUSIONS: Among patients, PWIDs had a lower awareness of their HCV-Ab positivity and had previously received less treatments. Saliva test allowed to achieve a more rapid result, stage, and treatment approach. More than 80% of patients underwent treatment, without differences between PWIDs and non-PWIDs. Linkage to care during prison transfer allowed to avoid unplanned interruptions and offered more chances to reach the end of treatment.
BACKGROUND:HCV infection among vulnerable populations is currently a major issue for HCV elimination program. Incarcerated people and people who inject drugs (PWIDs) are key population groups potentially at high risk for HCV infection. Our aim was to evaluate an extended program of screening, staging and treatment in Italian prison settings. METHODS:Patients from eight prisons in five different Italian Regions were enrolled. HCV saliva test (QuickOral Test®) was offered. Data on infection awareness and illicit drug use were also collected. Positive patients underwent early HCV RNA evaluation, staging and prescription on DAAs treatment. The definition of PWID was based on self-reported injecting drug use extracted from medical records (injecting drug use during the previous six months). RESULTS: A total of 2,376 out of 2,687 individuals (88%) was tested. The median (IQR) age was 42 (32-50) years. PWIDs were 537out of 2,376 (23%). Prevalence of HCV antibodies was 10.4% (248/2,376). PWIDs had a lower awareness of their HCV-Ab positivity than non-PWIDs (p-value <0.001). Furthermore, PWIDs were less likely to be previously treated than non-PWIDs (78% vs 96%, p-value= 0.017). Active infection was found in 41% of patients (101/248). Overall, 61% HCV-positive were PWIDs, with 44% HCV RNA positive. HCV therapy was prescribed to 83% (84/101) of patients with active HCV infection and 67% of these (56/84) were PWIDs. Prescription for HCV treatment in PWIDs accounted for 84% (56/67) (while for non-PWIDs was 82% (28/34) p-value: 0.88. Seventeen patients were referred to a Specialist in other prisons because they were going to be transferred soon to another prison. EOT, as well as SVR12 were achieved in 98% (82/84) treated patients. CONCLUSIONS: Among patients, PWIDs had a lower awareness of their HCV-Ab positivity and had previously received less treatments. Saliva test allowed to achieve a more rapid result, stage, and treatment approach. More than 80% of patients underwent treatment, without differences between PWIDs and non-PWIDs. Linkage to care during prison transfer allowed to avoid unplanned interruptions and offered more chances to reach the end of treatment.
Authors: Vito Fiore; Elena Rastrelli; Giordano Madeddu; Roberto Ranieri; Andrea De Vito; Ruggero Giuliani; Giulio Di Mizio; Matteo Bolcato; Giuseppe De Matteis; Anna Maria Ialungo; Serena Dell'Isola; Giulio Starnini; Sergio Babudieri Journal: BMC Infect Dis Date: 2022-07-07 Impact factor: 3.667
Authors: Vito Fiore; Giuseppe De Matteis; Emanuele Pontali; Andrea De Vito; Sandro Panese; Nicholas Geremia; Ivana Maida; Stefania Artioli; Giulio Starnini; Giordano Madeddu; Sergio Babudieri Journal: Front Public Health Date: 2022-10-04
Authors: Dana Busschots; Cécile Kremer; Rob Bielen; Özgür M Koc; Leen Heyens; Christian Brixko; Pierre Laukens; Hans Orlent; Pascal Bilaey; Francis De Smet; Geert Hellemans; Gaetan Muyldermans; Luk Van Baelen; Niel Hens; Hans Van Vlierberghe; Geert Robaeys Journal: BMC Infect Dis Date: 2021-07-27 Impact factor: 3.090