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BRIEF COMMUNICATION

Treatment of Chronic Hepatitis C in a State Correctional Facility

Scott A. Allen, MD; Anne C. Spaulding, MD; Albert M. Osei, MD; Lynn E. Taylor, MD; Asya M. Cabral, MPH; and Josiah D. Rich, MD, MPH

4 February 2003 | Volume 138 Issue 3 | Pages 187-190

Background: Approximately 1 in 4 of the nearly 2 million individuals in state and federal correctional facilities are infected with hepatitis C virus (HCV). Currently, there are few reports of treatment outcomes of this common infection in this setting.

Objective: To describe HCV therapy in the incarcerated setting.

Design: Retrospective, descriptive observational study.

Setting: Rhode Island Department of Corrections, Cranston, Rhode Island.

Patients: 93 inmates with chronic HCV infection.

Intervention: Interferon- with ribavirin.

Measurements: HCV RNA levels 6 months after treatment.

Results: Response rates are similar to previously published rates achieved in the community; 63% (50 of 79) of patients achieved viral clearance after 6 months of therapy, and 46% (26 of 57) achieved sustained response 6 months after treatment.

Conclusion: The incarcerated population (which is disproportionately affected by addiction and psychiatric illness) can be effectively treated for HCV infection with interferon and ribavirin. The correctional setting may provide an opportunity to safely treat patients with these two challenging comorbid conditions.

Editors' Notes Context Hepatitis C virus (HCV), the most common bloodborne virus in the United States, causes chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Hepatitis C virus is particularly prevalent among inmates of correctional facilities, but evidence regarding treatment of inmates is sparse. Contribution This observational study describes 90 HCV-infected inmates with sentences of 15 months or greater who were treated with antiviral therapy. Fifty of 79 who were treated for at least 6 months achieved viral clearance. Ten discontinued treatment because of side effects. One died of liver failure. Implications Antiviral therapy for chronic HCV is feasible in correctional settings, but costs and long-term outcomes are unknown. –The Editors

 

Author and Article Information

From Rhode Island Department of Corrections, Cranston, Rhode Island; and The Miriam Hospital and Brown Medical School, Providence, Rhode Island.

Grant Support: Dr. Josiah D. Rich is partially supported by grant P30-AI-42853 from the National Institutes of Health Center for AIDS Research (NIH CFAR).

Requests for Single Reprints: Josiah D. Rich, MD, MPH, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906; e-mail, jrich{at}lifespan.org.

Current Author Addresses: Drs. Allen, Spaulding, Osei, and Cabral: Rhode Island Department of Corrections, 39 Howard Avenue, Cranston, RI 02920.

Drs. Taylor and Rich: The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906.

Author Contributions: Conception and design: S.A. Allen, A.C. Spaulding, A.M. Osei, J.D. Rich.

Analysis and interpretation of the data: S.A. Allen, A.C. Spaulding, A.M. Osei, L.E. Taylor, J.D. Rich.

Drafting of the article: S.A. Allen, A.C. Spaulding, L.E. Taylor, J.D. Rich.

Critical revision of the article for important intellectual content: A.C. Spaulding, A.M. Osei, L.E. Taylor, J.D. Rich.

Final approval of the article: S.A. Allen, J.D. Rich.

Provision of study materials or patients: S.A. Allen.

Administrative, technical, or logistic support: A.C. Spaulding, A.M. Cabral.

Collection and assembly of data: S.A. Allen, A.C. Spaulding, A.M. Cabral.

Related articles in Annals:

Editorials
Adopting More Systematic Approaches to Hepatitis C Treatment in Correctional Facilities
Theodore M. Hammett

Annals 2003 138: 235-236. [Full Text]  

Summaries for Patients
Treatment for Hepatitis C Virus Infection among Inmates

Annals 2003 138: I-50. [Full Text]  

Letters
Correction: Treatment of Chronic Hepatitis C in a State Correctional Facility

Annals 2003 139: 605. [Full Text]  

Letters
Treatment of Chronic Hepatitis C in a State Correctional Facility
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Annals 2004 140: 150-151. [Full Text]  

Letters
Treatment of Chronic Hepatitis C in a State Correctional Facility
Scott Allen, Anne Spaulding, AND Josiah D. Rich

Annals 2004 140: 151. [Full Text]  

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