ABSTRACT
OBJECTIVES: Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Our aim was to create a permanent program of HCV elimination in a prison based on a "test and treat" strategy. METHODS: This open-label clinical trial was conducted in the Spanish prison "El Dueso" between May 2016 and July 2017. Viremic patients were treated with a ledipasvir-sofosbuvir regimen (8-12 weeks) according to the 2015 Spanish Guidelines. A teleconsultation program was established to follow-up patients from the hospital. Non-responders were submitted for a phylogenetic analysis and offered retreatment. An evaluation of new cases of HCV infection was performed every 6 months and upon release in all inmates. RESULTS: 847 (99.5%) inmates accepted to participate. HCV antibodies were present in 110 (13.0%) and 86 (10.2%) had detectable viremia. Most of them were genotype 1 or 3 (82.6%) and had Subject(s)
Antiviral Agents/therapeutic use
, Benzimidazoles/administration & dosage
, Disease Eradication/trends
, Environmental Exposure/adverse effects
, Fluorenes/administration & dosage
, Hepatitis C, Chronic/prevention & control
, Prisons
, Uridine Monophosphate/analogs & derivatives
, Adult
, Aged
, Disease Eradication/methods
, Disease Eradication/standards
, Female
, Follow-Up Studies
, Hepacivirus/drug effects
, Hepacivirus/isolation & purification
, Hepatitis C Antibodies/isolation & purification
, Hepatitis C, Chronic/blood
, Hepatitis C, Chronic/transmission
, Hepatitis C, Chronic/virology
, Humans
, Male
, Middle Aged
, Practice Guidelines as Topic
, Prisoners
, Program Evaluation
, Sofosbuvir
, Spain
, Sustained Virologic Response
, Uridine Monophosphate/administration & dosage
, Viral Load
, Viremia/diagnosis
, Viremia/drug therapy
, Viremia/virology
, Young Adult