Theme: Models of Care Year: 2019
Background:
Incarcerated people are considered as a population at high risk of HCV infection due to significant rate
of persons who inject drugs (PWID) in prisons and the practices which enable the transmission of HCV in
this environment. Moreover, the transmission of HCV in community continues once they discharged.
This intervention aims to facilitate the access of incarcerated patients to anti-HCV therapies
Description of model of care/intervention:
Initially, all incarcerated people were universally tested for anti-HCV with rapid test and those positive
for HCV RNA and genotype, in a large hospital’s lab. Patient history and registration to the HCV Platform
of Health Ministry was performed by thehepatology clinic in order for the therapies to be approved and
subsidized. Post-approval, medications were distributed on site to patients.
Effectiveness:
Among 580 prisoners tested 82 were positive for HCV (14.14%), 16 for HBV (2.41%) and 4 for HIV
(0.69%). 13 prisoners refused the test. HCV RNA was positive in 80/82 (97.56%) and the genotype
distribution was 1a 15%, 1b 8.3%, 2 8.3%, 3a 55%, 4 10%. There were 6.7% cirrhotics. Therapy was
approved for 41 patients as in 20 therapy could not be subsidized due to the lack of Social Security
Number. 16 were released, 2 had low viral load and 1 refused therapy. Sustained virologic response
(SVR) will be presented in the meeting.
Conclusion and next steps:
Prevalence of HCV in prisons is high in Greece and this intervention is an important step towards HCV
elimination. It is crucial Access4All be implemented periodically so as to be effective because prison’s
population is continuously renewed. Action needed in order to overcome the last barriers in HCV
treatment initiation to all incarcerated patients without limitations
Disclosure of Interest Statement:
Nothing to disclosure