Treatment effectiveness and side effects of patients with hepatitis C in the prisons of Southern Taiwan: a real-life retrospective analysis

• Published in: BMJ open 2023-06, Vol.13 (6), p.e070490-e070490
• Main Authors: Tsai, Yu-Chi, Yu, Ming-Lung, Ko, Chou-Yuan, Hsin, Yi-Hsiang, Tsai, Qi-Zhang, Huang, Chien-Wei
• Format: Article
• Language: English
• Subjects: Adult; Antiviral Agents - adverse effects; Asymptomatic; Chronic illnesses; Correctional institutions; Data collection; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Female; Gastroenterology and Hepatology; Genotype; Genotype & phenotype; Hepacivirus - genetics; Hepatitis B; Hepatitis C; Hepatitis C - drug therapy; Hepatitis C, Chronic - drug therapy; hepatobiliary disease; hepatology; Humans; infection control; Infections; infectious diseases; Kidney diseases; Laboratories; Liver cancer; Liver cirrhosis; Liver Cirrhosis - drug therapy; Liver diseases; Male; microbiology; Patients; Prisoners; Prisons; Retrospective Studies; Sofosbuvir - adverse effects; Taiwan - epidemiology; Treatment Outcome; Ultrasonic imaging
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-070490

ObjectiveHepatitis C is an important risk factor for cirrhosis and liver cancer in the Taiwanese population. Domestic prisons reported a higher rate of hepatitis C infection than the national average. Efficient and effective treatment of patients with hepatitis C in prisons is required to decrease the number of infections. This study analysed the effectiveness of hepatitis C treatment and its side effects in prison patients.DesignThis retrospective analysis included adult patients with hepatitis C who received direct-acting antiviral agents between 2018 and 2021.SettingThe special hepatitis C clinics in the two prisons were run by a medium-sized hepatitis C treatment hospital in Southern Taiwan. Three direct-acting antiviral agents, sofosbuvir/ledipasvir for 12 weeks, glecaprevir/pibrentasvir for 8 or 12 weeks and sofosbuvir/velpatasvir for 12 weeks, were adopted based on patient characteristics.Participants470 patients were included.Outcome measureThe sustained virological response at 12 weeks after the end of treatment was compared between the different groups.ResultsMost of the patients were men (70.0%) with a median age of 44 years. The most prevalent hepatitis C virus genotype was genotype 1 (44.26%). A total of 240 patients (51.06%) had a history of injectable drug use; 44 (9.36%) and 71 (15.11%) patients were coinfected with hepatitis B virus and HIV, respectively. Only 51 patients (10.85%) had liver cirrhosis. Most patients (98.30%) had normal renal function or no history of kidney disease. The patients had a sustained virological response achievement rate of 99.2%. The average incidence of adverse reactions during treatment was approximately 10%. Many of the adverse reactions were mild and resolved spontaneously.ConclusionDirect-acting antiviral agents are effective for treating hepatitis C in Taiwanese prisoners. These therapeutics were well-tolerated by the patient population.