High prevalence of late relapse and reinfection in prisoners treated for chronic hepatitis C
Version of Record online: 11 FEB 2010
© 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 25, Issue 7, pages 1276–1280, July 2010
How to Cite
Bate, J. P., Colman, A. J., Frost, P. J., Shaw, D. R. and Harley, H. A. (2010), High prevalence of late relapse and reinfection in prisoners treated for chronic hepatitis C. Journal of Gastroenterology and Hepatology, 25: 1276–1280. doi: 10.1111/j.1440-1746.2010.06295.x
- Issue online: 23 JUN 2010
- Version of Record online: 11 FEB 2010
- Accepted for publication 28 January 2010.
- chronic hepatitis C;
- late relapse;
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.