Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan.
BMJ Open. 2023 Jun 7;13(6):e070490. doi: 10.1136/bmjopen-2022-070490.
Hepatitis C is an important risk factor for cirrhosis and liver cancer in the Taiwanese population. Domestic prisons reported a higher rate of hepatitis C infection than the national average. Efficient and effective treatment of patients with hepatitis C in prisons is required to decrease the number of infections. This study analysed the effectiveness of hepatitis C treatment and its side effects in prison patients.
This retrospective analysis included adult patients with hepatitis C who received direct-acting antiviral agents between 2018 and 2021.
The special hepatitis C clinics in the two prisons were run by a medium-sized hepatitis C treatment hospital in Southern Taiwan. Three direct-acting antiviral agents, sofosbuvir/ledipasvir for 12 weeks, glecaprevir/pibrentasvir for 8 or 12 weeks and sofosbuvir/velpatasvir for 12 weeks, were adopted based on patient characteristics.
470 patients were included.
The sustained virological response at 12 weeks after the end of treatment was compared between the different groups.
Most of the patients were men (70.0%) with a median age of 44 years. The most prevalent hepatitis C virus genotype was genotype 1 (44.26%). A total of 240 patients (51.06%) had a history of injectable drug use; 44 (9.36%) and 71 (15.11%) patients were coinfected with hepatitis B virus and HIV, respectively. Only 51 patients (10.85%) had liver cirrhosis. Most patients (98.30%) had normal renal function or no history of kidney disease. The patients had a sustained virological response achievement rate of 99.2%. The average incidence of adverse reactions during treatment was approximately 10%. Many of the adverse reactions were mild and resolved spontaneously.
Direct-acting antiviral agents are effective for treating hepatitis C in Taiwanese prisoners. These therapeutics were well-tolerated by the patient population.
丙型肝炎是台湾人群肝硬化和肝癌的重要危险因素。国内监狱报告的丙型肝炎感染率高于全国平均水平。需要对监狱中的丙型肝炎患者进行高效和有效的治疗，以减少感染人数。本研究分析了监狱患者丙型肝炎治疗的效果及其副作用。
这项回顾性分析包括 2018 年至 2021 年间接受直接作用抗病毒药物治疗的成年丙型肝炎患者。
南部台湾一家中型丙型肝炎治疗医院运营的两所监狱的特殊丙型肝炎诊所。根据患者特征，采用三种直接作用抗病毒药物，即索磷布韦/维帕他韦 12 周、格卡瑞韦/哌仑他韦 8 或 12 周和索磷布韦/伏西瑞韦 12 周。
共纳入 470 例患者。
比较不同组治疗结束后 12 周时的持续病毒学应答。
大多数患者为男性（70.0%），中位年龄为 44 岁。最常见的丙型肝炎病毒基因型为基因型 1（44.26%）。共有 240 例（51.06%）有注射吸毒史；44 例（9.36%）和 71 例（15.11%）患者分别合并乙型肝炎病毒和 HIV 感染。仅有 51 例（10.85%）患者患有肝硬化。大多数患者（98.30%）的肾功能正常或无肾脏疾病史。患者的持续病毒学应答率为 99.2%。治疗过程中不良反应的平均发生率约为 10%。许多不良反应为轻度，可自行缓解。
直接作用抗病毒药物治疗台湾监狱囚犯的丙型肝炎有效。这些疗法在患者人群中具有良好的耐受性。
