title: Comparison of hepatitis C virus treatment between incarcerated and community patients.
abstract: The prevalence of chronic hepatitis C virus (HCV) infection among incarcerated individuals in the United States is estimated to be between 12% and 31%. HCV treatment during incarceration is an attractive option because of improved access to health care and directly observed therapy. We compared incarcerated and nonincarcerated HCV-infected patients evaluated for treatment at a single academic center between January 1, 2002 and December 31, 2007. During this period, 521 nonincarcerated and 388 incarcerated patients were evaluated for HCV treatment. Three hundred and nineteen (61.2%) nonincarcerated patients and 234 (60.3%) incarcerated patients underwent treatment with pegylated interferon and ribavirin. Incarcerated patients were more likely to be male, African-American race, and have a history of alcohol or intravenous drug use. Treated incarcerated patients were less likely to have genotype 1 virus and were less likely to have undergone previous treatment. There was a similar prevalence of coinfection with human immunodeficiency virus (HIV) in both groups. A sustained viral response (SVR) was achieved in 97 (42.9%) incarcerated patients, compared to 115 (38.0%) nonincarcerated patients (P = 0.304). Both groups had a similar proportion of patients that completed a full treatment course. Stepwise logistic regression was conducted, and the final model included full treatment course, non-genotype 1 virus, younger age at treatment start, and negative HIV status. Incarceration status was not a significant predictor when added to this model (P = 0.075).
  
  
  CONCLUSIONS
  In a cohort of HCV-infected patients managed in an academic medical center ambulatory clinic, incarcerated patients were as likely to be treated for HCV and as likely to achieve an SVR as nonincarcerated patients.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-5124, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Rice
authors.forename: David
authors.initials: D
authors.lastname: Burnett
authors.forename: Helena
authors.initials: H
authors.lastname: Tsotsis
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Lindstrom
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Cornett
authors.forename: Patricia
authors.initials: P
authors.lastname: Voermans
authors.forename: Jill
authors.initials: J
authors.lastname: Sawyer
authors.forename: Rob
authors.initials: R
authors.lastname: Striker
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lucey
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000998:Antiviral Agents / Q000627:therapeutic use*; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011329:Prisoners / Q000706:statistics & numerical data*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012111:Residence Characteristics; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000821:virology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a