Document Detail

High prevalence of late relapse and reinfection in prisoners treated for chronic hepatitis C.
MedLine Citation:
PMID:  20594255     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM: Prisoners have a high prevalence of injection drug use (IDU) and chronic hepatitis C (CHC) infection. Treatment of CHC in these patients is effective; however, their long-term outcomes following treatment are unknown. We determined the durability of a sustained virological response (SVR) in prisoners treated for CHC. METHODS: Patients were treated as part of routine clinical practice with interferon (IFN) and ribavirin. A retrospective review of medical records and a computerized pathology system was performed for clinical and laboratory information. RESULTS: Seventy-four prisoners (70 males, mean age 34 years, IDU in 55%) were evaluable for a SVR over a 12-year period to December 2008; the mean follow-up period was 1243 days. Genotype 1, 2, 3, and 6 infection was present in 18, three, 38 and three patients, respectively; the genotype was unknown in 12. Three out of 52 biopsied had cirrhosis. Standard IFN was administered to 25 (34%; 11 with ribavirin), and 49 received pegylated IFN and ribavirin; one did not complete treatment, and two had breakthrough relapses. The end-of-treatment response was achieved in 57 and SVR in 53; 14 were non-responders. Five male patients, four with unknown genotypes and treated with standard IFN alone, relapsed late (following SVR, 9%). Five patients, all treated with pegylated IFN and ribavirin, were reinfected (one prior to and four following SVR). CONCLUSIONS: Prisoners are often successfully treated for CHC. However, this retrospective study indicates that there is a high (17%) prevalence of late recurrence of viremia that is likely a reflection of reinfection due to ongoing risk-taking behavior.
John P Bate; Anton J Colman; Peter J Frost; David R Shaw; Hugh A J Harley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  25     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1276-80     Citation Subset:  IM    
Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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MeSH Terms
Antiviral Agents / therapeutic use*
Drug Therapy, Combination
Drug Users* / statistics & numerical data
Hepacivirus / genetics
Hepatitis C, Chronic / diagnosis,  drug therapy*,  epidemiology,  transmission
Interferons / therapeutic use
Prisoners* / statistics & numerical data
RNA, Viral / blood
Retrospective Studies
Ribavirin / therapeutic use
South Australia / epidemiology
Substance Abuse, Intravenous / complications*,  epidemiology
Time Factors
Treatment Outcome
Viral Load
Reg. No./Substance:
0/Antiviral Agents; 0/RNA, Viral; 36791-04-5/Ribavirin; 9008-11-1/Interferons
Comment In:
J Gastroenterol Hepatol. 2010 Jul;25(7):1184-6   [PMID:  20594243 ]

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