Viruses (Feb 2022)

Hepatitis C Screening and Treatment Program in Hungarian Prisons in the Era of Direct Acting Antiviral Agents

  • Klára Werling,
  • Béla Hunyady,
  • Mihály Makara,
  • Krisztina Nemesi,
  • Gábor Horváth,
  • Ferenc Schneider,
  • Judit Enyedi,
  • Zsófia Müller,
  • Miklós Lesch,
  • Zoltán Péterfi,
  • Tamás Tóth,
  • Judit Gács,
  • Zsuzsanna Fehér,
  • Eszter Ujhelyi,
  • Emese Molnár,
  • Anna Nemes Nagy

DOI
https://doi.org/10.3390/v14020308
Journal volume & issue
Vol. 14, no. 2
p. 308

Abstract

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A hepatitis C virus (HCV) screening and treatment program was conducted in Hungarian prisons on a voluntary basis. After HCV-RNA testing and genotyping for anti-HCV positives, treatments with direct-acting antiviral agents were commenced by hepatologists who visited the institutions monthly. Patients were supervised by the prisons’ medical staff. Data were retrospectively collected from the Hungarian Hepatitis Treatment Registry, from the Health Registry of Prisons, and from participating hepatologists. Eighty-four percent of Hungarian prisons participated, meaning a total of 5779 individuals (28% of the inmate population) underwent screening. HCV-RNA positivity was confirmed in 317/5779 cases (5.49%); 261/317 (82.3%) started treatment. Ninety-nine percent of them admitted previous intravenous drug use. So far, 220 patients received full treatment and 41 patients are still on treatment. Based on the available end of treatment (EOT) + 24 weeks timepoint data, per protocol sustained virologic response rate was 96.8%. In conclusion, the Hungarian prison screening and treatment program, with the active participation of hepatologists and the prisons’ medical staff, is a well-functioning model. Through the Hungarian experience, we emphasize that the “test-and-treat” principle is feasible and effective at micro-eliminating HCV in prisons, where infection rate, as well as history of intravenous drug usage, are high.

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