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Prisoners have a high prevalence of injection drug use and chronic hepatitis C infection.
Treatment of chronic Hepatitis C in these patients is effective; however, their long-term outcomes following treatment are unknown.
Professor Hugh Harley and colleagues from Australia determined the durability of a sustained virological response in prisoners treated for chronic Hepatitis C.
Patients were treated as part of routine clinical practice with interferon (IFN) and ribavirin.
The researchers performed a retrospective review of medical records and a computerized pathology system for clinical and laboratory information.
The research team evaluated 74 prisoners for a sustained virological response over a 12-year period to 2008.
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| There is a 17% prevalance of late recurrence of viremia |
| Journal of Gastroenterology & Hepatology |
The mean follow-up period was 1243 days.
Genotype 1, 2, 3, and 6 infection was present in 18, 3, 38 and 3 patients, respectively.
The research team found that the genotype was unknown in 12.
The researchers found that 3 out of 52 biopsied had cirrhosis.
Standard IFN was administered to 25, and 49 received pegylated IFN and ribavirin.
The researchers observed that 1 did not complete treatment, and 2 had breakthrough relapses.
The end-of-treatment response was achieved in 57, and sustained virological response in 53, of which 14 were non-responders.
The team noted that 5 male patients, 4 with unknown genotypes, and treated with standard IFN alone, relapsed late.
The researchers identified 5 patients, all treated with pegylated IFN and ribavirin, who were reinfected.
Professor Harley's concludes, "Prisoners are often successfully treated for chronic Hepatitis C.
However, this retrospective study indicates that there is a 17% prevalance of late recurrence of viremia that is likely a reflection of reinfection due to ongoing risk-taking behavior."
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