Chew Kara W, Allen Scott A, Taylor Lynn E, Rich Josiah D, Feller Edward
Department of Medicine, University of California at San Francisco, San Francisco, CA 94115, USA.
J Clin Gastroenterol. 2009 Aug;43(7):686-91. doi: 10.1097/MCG.0b013e31818dd94c.
To report our experience with pegylated interferon and ribavirin treatment of hepatitis C virus (HCV) RNA-positive inmates at the Rhode Island Department of Corrections.
An estimated 1 out of 3 HCV-infected individuals will spend time in a jail or prison within a 1-year period, making prisons a unique setting for management of chronic HCV.
Chart review of all inmates identified as having initiated HCV treatment between October 2000 and April 2004. HCV-infected individuals were identified by HCV antibody screening at intake for known risk factors, elevated aminotransferase levels, or per individual request. Treatment followed standard guidelines with weight-based dosing of pegylated interferon-alpha2b and ribavirin. End points were completion of therapy plus 6 months for sustained virologic response (SVR), therapy discontinuation, and loss to follow-up.
The cohort included 71 male patients, was mostly white (80%), and genotype 1 (65%). All 9 African Americans (AA) had genotype 1. Of 59 patients having liver biopsy, 41 had early stage disease. Overall SVR was 28%. Response rate was lower for genotype 1 compared with genotypes 2 and 3 (SVR 18% vs. 60% and 50%). Of inmates with genotype 1, no difference existed in treatment response by race (SVR 22% AA vs. 18% white). Thirty-three patients completed treatment, 26 stopped for side effects, and 5 for initial nonresponse. Eleven were lost to follow-up.
Acceptable HCV treatment outcomes can be achieved in prisons. Our small study indicates no difference in treatment response by AA versus white race for genotype 1.
报告我们使用聚乙二醇化干扰素和利巴韦林治疗罗德岛惩教部丙型肝炎病毒（HCV）RNA阳性囚犯的经验。
估计每3名丙型肝炎病毒感染者中就有1人会在1年内入狱，这使得监狱成为管理慢性丙型肝炎病毒的独特场所。
对2000年10月至2004年4月期间所有开始接受丙型肝炎病毒治疗的囚犯进行病历审查。通过对已知风险因素、转氨酶水平升高或个人要求进行入所时的丙型肝炎病毒抗体筛查来确定丙型肝炎病毒感染者。治疗遵循标准指南，根据体重给予聚乙二醇化干扰素-α2b和利巴韦林。终点指标为治疗完成加6个月的持续病毒学应答（SVR）、治疗中断和失访。
该队列包括71名男性患者，大多数为白人（80%），基因型为1型（65%）。所有9名非裔美国人（AA）均为基因型1型。在59名进行肝活检的患者中，41名患有早期疾病。总体SVR为28%。与基因型2和3相比，基因型1的应答率较低（SVR分别为18%、60%和50%）。在基因型1的囚犯中，不同种族的治疗应答无差异（非裔美国人SVR为22%，白人SVR为18%）。33名患者完成治疗，26名因副作用停药，5名因初始无应答停药。11名失访。
在监狱中可以实现可接受的丙型肝炎病毒治疗结果。我们的小型研究表明，对于基因型1，非裔美国人与白人在治疗应答方面没有差异。
