Treatment of the Hepatitis C in Prison in France in 2011-2012: More Patients Treated in Fewer Medical Jailhouse Units : Results of National Practice Survey

Author: André-Jean REMY and Medical Jailhouse Units of France

Theme: Clinical Research Year: 2015

Introduction: In France access to antiviral treatment was normally equal as people outside. National 2005 study of practices showed that with PEG interferon ribavirin therapy, only 14 % HCV inmates were treated. Recent national health institute studies did not allow to answer question of percentage of inmates treated for hepatitis C. Did triple therapy with telaprevir or boceprevir increase or decrease patients’ percentage treated? Objectifs and methods : Our objective was to study in national survey, in retrospective and prospective vision over 2011 and 2012, number of patients treated by dual therapy and triple therapy in MJU. It was postal and mail survey. Results : 77 MJU over 182 participated for 38998 inmates ; hepatitis screening was always systematically proposed; 30290 serology C were realized in 2011, 31580 in 2012; 2012 rate was 4.5 % positivity. Followed patients were 1579 in 2011, 1717 in 2012; 49 % of MJU had regular hepatology consultation; to evaluate liver fibrosis 227 FIBROSCAN* and 511 FIBROTEST / FIBROMETRE were realized in 2012 but only 2 liver biopsy. In 2011, 301 patients were treated (19 % of HCV patients); in 2012, 497 patients (29 %). Triple therapy constituted 12 % of treatments in 2011, 39 % in 2012 (telaprevir 80/72 %, boceprevir 20/28 % in 2011/2012); 42 % of MJU introduced no treatment in 2011 (77 % any triple therapy), 56 % in 2012 (66 % any triple therapy). Conclusions : 1/ frequent HCV patients HCV in jailhouses, 2/ good screening and diagnosis and using widely not invasive methods of fibrosis 3/ but very different practices for hepatitis treatment between few MJU treating a lot of patients and a lot of MJU treating none. Compared with study of 2005, percentage of treated patients was doubled but percentage of MJU involved decreased in 45 %.

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