550-555DOI: 10.17235/reed.2019.6152/2018
Germán Jiménez Galán, Carlos Alia Alia, Milagros Vegue González, Rosa M.ª García Berriguete, Francisco Fernández González, Conrado M. Fernández Rodríguez, Mario González Fernández, María Luisa Gutiérrez García, Juan Emilio Losa, María Velasco, Leonor Moreno, Rafael Hervás, Alberto Delgado-Iribarren, Gregorio Palacios García-Cervigón,
Resumen
Background: micro-elimination has been recently proposed as an efficient strategy to achieve global hepatitis C virus (HCV) elimination. The Spanish Health Ministry Strategic Plan for hepatitis C infection highlighted intervention in prisons as a priority action. However, there are important barriers associated with the specialized care provision to the penitentiary population.
Aims: to assess the contribution of telemedicine for HCV elimination in a correctional facility in Spain.
Methods: an open label program of HCV elimination via telemedicine was started on February 3rd, 2015 in a large penitentiary of 1,200 inmates, as an alternative to referring patients to specialists. An anonymous satisfaction survey was performed among a random sample of inmates and all participating doctors.
Results: the prevalence of HCV viremia prior to program initiation was 12.4%. One hundred and thirty-one patients received DAA HCV treatment during the period 2015-2018; 42.74% had a HCV-HIV co-infection. Overall, 97% achieved a sustained virological response (SVR). A second regime of DAA successfully rescued non-responder patients and the HCV prevalence was zero at the end of the program. Satisfaction was high or very high according to 67% of inmates and all participating doctors.
Conclusion: telemedicine is an effective tool for HCV elimination in penitentiary correctional facilities where referral to specialists is difficult. The extensive use of this technology should be recommended in this setting in order to facilitate equitable access to specialized care.
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Bibliografía
1. Strategic Plan for Tackling Hepatitis C in the Spanish National Health System. Office of the Secretary for health and consumer affairs. http://www.easl.eu/medias/files/eu/PEAHC_v2_eng.pdf 1 Oct 2018
2. Lazarus J.V, Wiktor S, Colombo M, Thurzs M. Micro-elimination. A path to global elimination of hepatitis C. J Hepatol 2017; 67 : 665–666.
3. Astier Peña P, Divar Conde JM. Calidad Asistencial en la sanidad penitenciaria Española. Secretaria general de instituciones penitenciarias. Subdirección general de coordinación de sanidad penitenciaria. Ministerio del interior. Mayo 2010. http://www.institucionpenitenciaria.es/web/export/sites/default/datos/descargables/bEpidemiologicos/SACACOORDINACINONDESANIDAD9-4-10.pdf Accesed Dec 30th 2018.
4. Ministerio de Interior – March 2017 data (www.institucionpenitenciaria.es); Comparecencia del Ministerio de Interior al Senado con el nº 15869 (13-1-2017)
5. Sanidad en prisión – APDHA; Tratamiento VHC en la población reclusa, CIBERESP (Andrés Marco); análisis IQVIA
6. Cuadrado A, Llerena S, Cobo C, Pallás JR, Mateo M, Cabezas J et al Microenvironment Eradication of Hepatitis C: A Novel Treatment Paradigm Am J Gastroenterol 2018;113:1639-1648
7. Saiz de la Hoya P, Marco A, Garcia-Guerrero J, et al. Hepatitis C and B prevalence in Spanish prisons. Eur J Clin Microbiol Infect Dis. 2011;30:857–62.
8. WHO. Combating hepatitis B and C to reach elimination by 2030 Advocacy brief
https://www.who.int/hepatitis/publications/hep-elimination-by-2030-brief/en/
Accesed on Dec 30, 2018.
9. Hernández-Conde M, Fernández I, Perelló C el al. Effectiveness and safety of elbasvir/grazoprevir therapy in patients with chronic HCV infection: Results from the Spanish HEPA-C real-world cohort. J Viral Hepat. 2018 Sep 28. doi: 10.1111/jvh.13008. [Epub ahead of print] PubMed PMID: 30265418.
10. Perelló C, Carrión JA, Ruiz-Antorán B et al Spanish Collaborative Group for the Study of the Use of Hepatitis C Direct-Acting Drugs. Effectiveness and safety of ombitasvir, paritaprevir, ritonavir ± dasabuvir ± ribavirin: An early access programme for Spanish patients with genotype 1/4 chronic hepatitis C virus infection. J Viral Hepat. 2017 Mar;24(3):226-237. doi: 10.1111/jvh.12637. Epub 2016 Dec 15. PubMed PMID: 27976491.
11. Alonso S, Riveiro-Barciela M, Fernandez I, Rincón D, Real Y, Llerena S et al. Effectiveness and safety of sofosbuvir-based regimens plus an NS5A inhibitor for patients with HCV genotype 3 infection and cirrhosis. Results of a multicenter real-life cohort. J Viral Hepat. 2017;24:304-311.
12. Llaneras J, Riveiro-Barciela M, Esteban R et al. Real-life effectiveness and safety of velpatasvir/sofosbuvir/voxilaprevir for previously DAA treated patients with chronic hepatitis C The Liver Meeting (AASLD), San Francisco, United States. 9th November 2018
13. Puigvehi M, Albillos A, Viu A et al. Effectiveness and Safety of Glecaprevir/Pibrentasvir for the Pangenotypic Treatment of Chronic Hepatitis C: Results from a Spanish Cohort (Hepa-C) The Liver Meeting (AASLD) ,San Francisco, United States. 9th November 2018
14. Brown R, Hezode Ch, Wang S, Buti M, Chuang WL, Aguilar H et al. Preliminary efficacy and safety of 8-weeks Glecaprevir/Pibrentasvir in patients with HCV genotype 1-6 infection and compensated cirrhosis: The expedition-8 Study. AASLD-2018
15. Calleja JL , Crespo J , Rincón D et al. The Spanish Group for the Study of the Use of Direct-acting Drugs Hepatitis C Collaborating Group Effectiveness, safety and clinical outcomes of direct-acting antiviral therapy in HCV genotype 1 infection: Results from a Spanish real-world cohort, J Hepatol 2017; 66: 1138–114
16. Morey S, Hamoodi A, Jones D et al. Increased diagnosis and treatment of hepatitis C in prison by universal offer of testing and use of telemedicine J Viral Hepat. 2018 Oct 13. doi: 10.1111/jvh.13017. [Epub ahead of print]
17. Pan JJ, Bao F, Du E, Skillin C, Frenette CT, Waalen J, Alaparthi L, Goodman ZD, Pockros PJ. Morphometry Confirms Fibrosis Regression From Sustained Virologic Response to Direct-Acting Antivirals for Hepatitis C. Hepatol Commun. 2018;2:1320-1330
18. Turnes J, Domínguez-Hernández R, Casado MÁ Value and innovation of direct-acting antivirals: long-term health outcomes of the strategic plan for the management of hepatitis C in Spain Rev Esp Enferm Dig. 2017;109:809-817.
19. Goñi Esarte S, Juanbeltz R, Martínez-Baz I, Castilla Catalán J, San Miguel R, Herrero Santos JI, Jose Manuel Zozaya JM Long-term changes on health related quality of life in patients with chronic hepatitis C after viral clearance with direct-acting antiviral agents. Rev Esp Enf Dig 2019 In press
20. Pontali E, Fiore V, Ialungo AM, Ranieri R, Mollaretti O, Barbarini G, Marri D, Prestileo T, Dell'Isola S, Rastrelli E, Leo G, Starnini G, Babudieri S, Madeddu G. Treatment with direct-acting antivirals in a multicenter cohort of HCV-infected inmates in Italy Int J Drug Policy. 2018; 59:50-53.