Delivering therapy for hepatitis C virus infection to incarcerated HIV-seropositive patients.
The increase in morbidity and mortality due to end-stage liver disease has fueled recent guidelines that recommend consideration of treatment for hepatitis C in human immunodeficiency virus (HIV)-infected patients. Unfortunately, studies indicate that few patients coinfected with HIV and hepatitis C virus (HCV) are treated for their underlying hepatitis because of ongoing substance abuse, depression, chaotic lifestyles, homelessness, and perceived nonadherence. The structured environment of the prison system enables clinicians to provide complicated therapies for HCV to HIV-infected patients in combination with substance abuse programs. Furthermore, adherence to and adverse effects of therapy can be closely monitored. Offering treatment for HCV infection during incarceration to HIV-seropositive persons is highly efficient and targets underserved minority patients who have limited access to care in the community.
McGovern
Barbara
B
Division of Infectious Diseases, Lemuel Shattuck Hospital, Jamaica Plain, MA 02130, USA. bmcgovern@tufts-nemc.org
Fiore
Joseph
J
Wurcel
Alysse
A
Taglienti
Paul
P
Bradley
Meg
M
Galvin
Susan
S
Libone
George
G
Ramsey
Jean
J
Molinaro-Gudas
Valerie
V
Drewniak
Stephen
S
Amick
Carol
C
Andalkar
Anjali
A
Scheft
Harriet
H
Bica
Ioana
I
D003710:Demography; D004347:Drug Interactions; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D008099:Liver / Q000473:pathology; D008297:Male; D011329:Prisoners; D012254:Ribavirin / Q000008:administration & dosage; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy; D016896:Treatment Outcome
D016898:Interferon-alpha; D012254:Ribavirin