Factors influencing compliance with Hepatitis C treatment in patients transitioning from prison to community-A summary scoping review

Current perspectives of viral hepatitis

Viral hepatitis represents a major danger to public health, and is a globally leading cause of death. The five liver-specific viruses: Hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus, and hepatitis E virus, each have their own unique epidemiology, structural biology, transmission, endemic patterns, risk of liver complications, and response to antiviral therapies. There remain few options for treatment, in spite of the increasing prevalence of viral-hepatitis-caused liver disease. Furthermore, chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality, even though effective treatments are available that could reduce or prevent most patients' complications. In 2016, the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030, along with a discussion of current gaps and prospects for both regional and global eradication of viral hepatitis. Today, treatment is sufficiently able to prevent the disease from reaching advanced phases. However, future therapies must be extremely safe, and should ideally limit the period of treatment necessary. A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral hepatitis. This review aims to summarize the current state of knowledge on each type of viral hepatitis, together with major innovations.

Health Education Initiatives for People Who Have Experienced Prison: A Narrative Review

Due to the selectiveness of criminal systems and the context of social vulnerability, there is a high prevalence of health problems among individuals with a history of incarceration. When there is an insufficient level of health care, prior clinical conditions can worsen, and health education can be a response to this problem. Health education is a process of building health knowledge that is intended to facilitate thematic appropriation by the population that enables people to access, understand, and use health-related information for health improvement. In the context of criminal justice, health education can contribute to the successful transition of people who have experienced prison from their custody to the community setting. This study aimed to identify, synthesize, and critically evaluate peer-reviewed evidence concerning health education initiatives developed during or after incarceration aimed at people released from prison. A narrative review methodology was used to analyze 19 studies about health education interventions for prisoners or people who were arrested. Initiatives were identified in five countries, which showed differences in approaches, with motivational interviewing and group sessions standing out in the studies. All of them were grouped into the following themes: HIV and other sexually transmitted infections, alcohol, opioids and other substances, tuberculosis, and women's health. We have not performed a quality assessment of the studies included (using checklists such as PRISMA, AMSTAR, or SANRA) as this study is a narrative review and was not intended to be a systematic review or meta-analysis. This review has the potential impact of informing future health education initiatives and policies for individuals transitioning from prison.

Self-reported and measured adherence to hepatitis C direct-acting antiviral therapy and sustained virologic response among people who inject drugs: The HERO study

BACKGROUND

Objective adherence measures, such as electronic blister pack (BP), for direct-acting antivirals (DAAs) for hepatitis C virus (HCV) treatment have high accuracy, but their use is limited in real practice settings. We examined the association of self-reported adherence using a visual analogue scale (VAS) with objective BP adherence and sustained virologic response (SVR) among people who inject drugs.

METHODS

We conducted secondary analyses using a subset of participants (N = 493) from the per-protocol sample of the HERO study, a pragmatic randomized trial of HCV treatment interventions that used both VAS and BP to measure adherence to a 12-week sofosbuvir/velpatasvir DAA regimen. Multivariable mixed-effects regression models tested the association of self-report adherence level with longitudinal weekly objective adherence. Multivariable logistic regression tested the association of self-report adherence with SVR.

RESULTS

The average VAS and BP adherences were 95.1 % (SD = 8.9 %) and 76.0 % (16.0 %), respectively, and the proportion of the participants achieving SVR was 92.9 %. The estimated adjusted mean objective adherence was significantly different (-16 %; 95 % CI: -22 %, -11 %, p < .001) between participants with 100 % and <80 % VAS adherence. The likelihood of SVR was significantly lower for those with <80 % VAS adherence [adjusted OR = 0.07; 95 % CI: 0.02, 0.24; p < .001] compared to those with 100 %.

CONCLUSION

Self-reported adherence overestimated objective adherence. However, higher self-report adherence was significantly associated with higher objective adherence. Also, self-reported adherence ≥80 % was significantly associated with SVR. Thus, the self-report measure has utility as a monitoring tool for adherence during DAA treatment.