1
|
Werling K, Hunyady B, Makara M, Nemesi K, Horváth G, Schneider F, Enyedi J, Müller Z, Lesch M, Péterfi Z, Tóth T, Gács J, Fehér Z, Ujhelyi E, Molnár E, Nemes Nagy A. Hepatitis C Screening and Treatment Program in Hungarian Prisons in the Era of Direct Acting Antiviral Agents. Viruses 2022; 14:v14020308. [PMID: 35215901 PMCID: PMC8876701 DOI: 10.3390/v14020308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 02/04/2023] Open
Abstract
A hepatitis C virus (HCV) screening and treatment program was conducted in Hungarian prisons on a voluntary basis. After HCV-RNA testing and genotyping for anti-HCV positives, treatments with direct-acting antiviral agents were commenced by hepatologists who visited the institutions monthly. Patients were supervised by the prisons’ medical staff. Data were retrospectively collected from the Hungarian Hepatitis Treatment Registry, from the Health Registry of Prisons, and from participating hepatologists. Eighty-four percent of Hungarian prisons participated, meaning a total of 5779 individuals (28% of the inmate population) underwent screening. HCV-RNA positivity was confirmed in 317/5779 cases (5.49%); 261/317 (82.3%) started treatment. Ninety-nine percent of them admitted previous intravenous drug use. So far, 220 patients received full treatment and 41 patients are still on treatment. Based on the available end of treatment (EOT) + 24 weeks timepoint data, per protocol sustained virologic response rate was 96.8%. In conclusion, the Hungarian prison screening and treatment program, with the active participation of hepatologists and the prisons’ medical staff, is a well-functioning model. Through the Hungarian experience, we emphasize that the “test-and-treat” principle is feasible and effective at micro-eliminating HCV in prisons, where infection rate, as well as history of intravenous drug usage, are high.
Collapse
Affiliation(s)
- Klára Werling
- Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, 1082 Budapest, Hungary
- Correspondence:
| | - Béla Hunyady
- Department of Gastroenterology, Somogy County Kaposi Mór Teaching Hospital, 7400 Kaposvár, Hungary;
- First Department of Internal Medicine, Clinical Center, University of Pécs, 7624 Pécs, Hungary;
| | - Mihály Makara
- National Institute of Hematology and Infectious Diseases, Szent László Site, South-Pest Central Hospital, 1097 Budapest, Hungary; (M.M.); (K.N.); (J.G.)
| | - Krisztina Nemesi
- National Institute of Hematology and Infectious Diseases, Szent László Site, South-Pest Central Hospital, 1097 Budapest, Hungary; (M.M.); (K.N.); (J.G.)
| | | | - Ferenc Schneider
- Department of Infectology, Markusovszky University Teaching Hospital, 9700 Szombathely, Hungary; (F.S.); (Z.F.)
| | - Judit Enyedi
- Department of Infectology, Markhot Ferenc Teaching Hospital and Clinic, 3300 Eger, Hungary;
- Department of Infectology, Dr. Kenessey Albert Hospital, 2660 Balassagyarmat, Hungary
| | - Zsófia Müller
- Department of Infectology, Szent György University Teaching Hospital of County Fejér, 8000 Székesfehérvár, Hungary;
| | - Miklós Lesch
- Department of Infectology, Szabolcs-Szatmár-Bereg County Hospitals Jósa András Teaching Hospital, 4412 Nyíregyháza, Hungary;
| | - Zoltán Péterfi
- First Department of Internal Medicine, Clinical Center, University of Pécs, 7624 Pécs, Hungary;
| | - Tamás Tóth
- Department of Internal Medicine and Oncology, Semmelweis University, 1083 Budapest, Hungary;
| | - Judit Gács
- National Institute of Hematology and Infectious Diseases, Szent László Site, South-Pest Central Hospital, 1097 Budapest, Hungary; (M.M.); (K.N.); (J.G.)
| | - Zsuzsanna Fehér
- Department of Infectology, Markusovszky University Teaching Hospital, 9700 Szombathely, Hungary; (F.S.); (Z.F.)
| | | | - Emese Molnár
- Department of Transfusiology, Semmelweis University, 1089 Budapest, Hungary;
| | - Anna Nemes Nagy
- Department of Health, Hungarian Prison Services, 1054 Budapest, Hungary;
| |
Collapse
|