A matched comparison study of hepatitis C treatment outcomes in the prison and community setting, and an analysis of the impact of prison release or transfer during therapy
A matched comparison study of hepatitis C treatment outcomes in the prison and community setting, and an analysis of the impact of prison release or transfer during therapy
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DOI：
10.1111/jvh.12580
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发表时间：
2016-12-01
影响因子：
2.5
通讯作者：
Hutchinson, S. J.
中科院分区：
文献类型：
--
作者：
Aspinall, E. J.;Mitchell, W.;Hutchinson, S. J.
囚犯是丙型肝炎（HCV）治疗的优先群体。虽然使用直接作用抗病毒药物（DAA）的治疗时间会缩短，但苏格兰近一半的监狱刑期太短，无法在释放前完成DAA治疗。本研究的目的是比较监狱和社区为基础的患者之间的治疗结果，并检查监狱释放或转移治疗期间的影响。一个国家数据库被用来比较监狱治疗发起人和匹配的社区样本之间的治疗结果。收集了额外的数据，以研究释放或转移对治疗结果的影响。在2009年至2012年期间感染基因型1/2/3/4并接受治疗的初治患者有资格入选。291名监狱新成员与1137名社区新成员匹配：SVRs分别为61%（95%CI 55%-66%）和63%（95%CI 60%-66%）。获得SVR的几率与囚犯身份无显著相关性（P= 0.33）。在未释放或转移、治疗期间转移或治疗期间释放的受试者中，SVR分别为74%（95% CI 65%-81%）、59%（95% CI 42%-75%）和45%（95% CI 29%-62%）。达到SVR的几率与释放显著相关（P
Prisoners are a priority group for hepatitis C (HCV) treatment. Although treatment durations will become shorter using directly acting antivirals (DAAs), nearly half of prison sentences in Scotland are too short to allow completion of DAA therapy prior to release. The purpose of this study was to compare treatment outcomes between prison- and community-based patients and to examine the impact of prison release or transfer during therapy. A national database was used to compare treatment outcomes between prison treatment initiates and a matched community sample. Additional data were collected to investigate the impact of release or transfer on treatment outcomes. Treatment-naive patients infected with genotype 1/2/3/4 and treated between 2009 and 2012 were eligible for inclusion. 291 prison initiates were matched with 1137 community initiates: SVRs were 61% (95% CI 55%-66%) and 63% (95% CI 60%-66%), respectively. Odds of achieving a SVR were not significantly associated with prisoner status (P=.33). SVRs were 74% (95% CI 65%-81%), 59% (95% CI 42%-75%) and 45% (95% CI 29%-62%) among those not released or transferred, transferred during treatment, or released during treatment, respectively. Odds of achieving a SVR were significantly associated with release (P