REMY Andre-Jean
Perpignan Hospital, France
Title: PH8 a french national study of completion rate of HCV treatment in prison
Biography
Biography: REMY Andre-Jean
Abstract
Background: Prevalence of viral hepatitis C is higher in prison environment than in the general population and is estimated of 4,8% in France. Systematic HCV screening on all inmates has been recommended in France since 1999. The impact in prison environment is little-known as based only on local studies. Inmate health care falls under USMP (Prison Setting Medical Unit), hospital specific units as by 1994 law. Access to antiviral C treatment for inmates has always been difficult in France, would it be for interferon and ribavirin or use of protease inhibitors, with less than 20% of treated patients. Arrival of DAA is an opportunity to propose treatment and the patient to accept it. In 2014, French guidelines recommended HCV carriers in prison should systematically be treated independently of stage of fibrosis; AAD treatment was permitted in 2015 without additional costs for hospitals. For prisoners, short treatment could be better to be treated in prison. Objectives: 1/ Evaluate completion rate of an 8-week antiviral C treatment by ledipasvir/sofosbuvir association in non-
cirrhotic genotype 1 patients in deprivation of liberty and achieve sustained virological response (SVR) 2/ Measure effectiveness of 8-week treatment (by protocol analysis).
Methodology: prospective non-interventional multicenter trial among inmates with chronic hepatitis C genotype 1 with fibrosis score F0 to F2 and who will receive a daily combination of sofosbuvir / ledipasvir during 8 weeks.
Results: for 100 first included patients: 91% men, mean age 37 years, contamination mode : drug injection 72%, nasal drug 9%, unknown 19%; genotype 1a 90%, initial liver fibroscan score: F0 66% F1 24% F2 10%; 95% have finished their antiviral treatment; only 5% stopped before end of 8 weekend and 5% have been responder/relapse; 91% have sustained virological response at time of these abstract.
Conclusion: It was first study of 8 weeks HCV treatment in prison; Almost all included patients have completed their treatment and are cured. Five percent of patients stopped the treatment because of cell promiscuity giving