Successful microelimination of HCV among patients in the Romanian prison system
Background: It is well known that prison is an at risk environment for blood borne diseases, so also a place where we can find and successfully treat patients that will eventually go back in the society. As the complaints from the HCV persons in detention were increasing The NIIDMB together with the NPA put up a joint project to seek and treat inmates.
Methods: In November-December 2020, the screening phase took place in 12 Prisons from the south region of Romania (about 12350 prisoners). A short video clip explained the intervention and after written consent, the inmates were tested for HCV Antigen. From 6057 tested, 364 were positive. Beginning 10 February, Ag positive inmates were brought weekly for the panel of analyses required by the National Insurance House Treatment protocol.
Results: From the 109 + patients brought to NIIDMB, 2 refused blood sampling, 9 had undetectable HCV, 2 were found with unknown HIV coinfections, 9 were not able to have complete dossiers till the approved deadline, thus only 87 received the treatment. All patients received Ombitasvir/Paritapravir/Ritonavir + Dasabuvir, for 2 or 3 months. The SVR was good in 83 patients, 4 having still detectable HCVRNA at week 12 after treatment. This 4 non responders were successfully treated with Sofosbuvir/Velpatasvir/Voxilaprevir for 12 weeks.
Conclusion: The study shows that even with some difficulties from Covid 19 restrictions, lack of accompanying prison officers and prisoner’s instability this is a treatable population with good cost efficiency and good reduction of HCV burden in the society. Acknowledgement: This intervention was possible through Sponsorship from Abbvie and Professor Doctor Matei Bals Foundation.