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Open Access Research article

Prevalence and epidemiological correlates and treatment outcome of HCV infection in an Italian prison setting

Micaela Brandolini1, Stefano Novati1, Annalisa De Silvestri2, Carmine Tinelli2, Savino Francesco Antonio Patruno3, Roberto Ranieri4 and Elena Seminari1*

Author Affiliations

1 Clinica di Malattie Infettive, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy

2 Servizio di Biometria e Statistica, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy

3 Divisione di Malattie Infettive e Tropicali, Fondazione IRCCS Policlinico San Matteo, Viale Camillo Golgi 19, 27100 Pavia, Italy

4 Medicina Protetta Ospedale San Paolo-Milano, Milan, Italy

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BMC Public Health 2013, 13:981  doi:10.1186/1471-2458-13-981

Published: 20 October 2013

Abstract

Background

The aim of the present study is to test in the feasibility of a screening programme for HCV infection in an Italian prison and to evaluate the treatment outcomes.

Method

Single-centre cross-sectional study carried out in Milan-Opera. The HCV infection prevalence was calculated on the imprisoned population on the January 31 2006, the data on treatment over the following 2 years. Treatment option offered to HCV chronically infected patients was then analysed, reasons for not being treated was evaluated.

Results

Of the 965 inmates, 695 were enrolled in the study, 682 (98%) were males, the median age was 43 years. There were 131 (18.8%) foreigners and 564 (81.2%) Italians. HCV seroprevalence was 22.4%(95% CI:19.4%-25.7%), 60 subjects (38.4%) being HIV co-infected too. Prevalence of HCV infection was significantly higher in HIVAb positive (89.6%; 95% CI:79.7%-95.7%) than in HIVAb negative (15.15%; 95% CI 12.6%-18.3%) (p<0.001). Among Italian inmates HCVAb positivity was significantly higher than among foreigners (p=0.0154). Among HCVAb positive patients, 135 subjects were HCV-RNA positive. Forty-seven (36%) had major clinical contraindication to treatment, 18 (13%) refused the treatment, 7 (5%) moved to other Institute and 27 (20%) were not evaluated by infectious disease specialists. Fifteen patients (43%) who received treatment were considered responders, 9 (26%) were non responders/relapsers, 6 (17%) interrupted treatment due to side effects and 5 (14%) were released during treatment and lost in follow-up.

Conclusions

This study indicates that the proportion of patients in a prison setting receiving diagnosis and treatment for HCV infection remained low.

Keywords:
HCV-infection; HCV-prevalence; Prison; HCV treatment; HIV-HCV coinfection