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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2022; 28(2): 263-274
Published online Jan 14, 2022. doi: 10.3748/wjg.v28.i2.263
Outreach onsite treatment with a simplified pangenotypic direct-acting anti-viral regimen for hepatitis C virus micro-elimination in a prison
Chun-Ting Chen, Ming-Ying Lu, Meng-Hsuan Hsieh, Pei-Chien Tsai, Tsai-Yuan Hsieh, Ming-Lun Yeh, Ching-I Huang, Yi-Shan Tsai, Yu-Min Ko, Ching-Chih Lin, Kuan-Yu Chen, Yu-Ju Wei, Po-Yao Hsu, Cheng-Ting Hsu, Tyng-Yuan Jang, Ta-Wei Liu, Po-Cheng Liang, Ming-Yen Hsieh, Zu-Yau Lin, Chung-Feng Huang, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Yu-Lueng Shih, Ming-Lung Yu
Chun-Ting Chen, Yu-Lueng Shih, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tri-Service General Hospital Penghu Branch, National Defense Medical Center, Penghu County 88041, Taiwan
Chun-Ting Chen, Tsai-Yuan Hsieh, Yu-Lueng Shih, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
Ming-Ying Lu, Meng-Hsuan Hsieh, Pei-Chien Tsai, Ming-Lun Yeh, Ching-I Huang, Yi-Shan Tsai, Yu-Min Ko, Ching-Chih Lin, Kuan-Yu Chen, Yu-Ju Wei, Po-Yao Hsu, Cheng-Ting Hsu, Tyng-Yuan Jang, Ta-Wei Liu, Po-Cheng Liang, Ming-Yen Hsieh, Zu-Yau Lin, Chung-Feng Huang, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Ming-Lung Yu, Division of Hepatobiliary, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
Meng-Hsuan Hsieh, Ming-Lun Yeh, Ching-I Huang, Yi-Shan Tsai, Yu-Min Ko, Ching-Chih Lin, Kuan-Yu Chen, Yu-Ju Wei, Po-Yao Hsu, Cheng-Ting Hsu, Tyng-Yuan Jang, Ta-Wei Liu, Po-Cheng Liang, Ming-Yen Hsieh, Zu-Yau Lin, Chung-Feng Huang, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Ming-Lung Yu, School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Ming-Lung Yu, National Pingtung University of Science and Technology, Pingtung 912, Taiwan
Author contributions: Chen CT and Yu ML drafted the manuscript; Tsai PC and Hsieh MH assisted with data collection and analysis; Yu ML and Shih YL made equal contributions; all authors participated in universal mass screening, immediate onsite treatment, read and approved the final manuscript.
Supported by the Kaohsiung Medical University, No. 108-2314-B-037-066 and No. DK107004; and the Kaohsiung Medical University Hospital, No. KMUH-108-8R05, No. KMUH-DK109002 and No. KMUH-DK109005-1.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Kaohsiung Medical University Hospital (IRB: KMUHIRB-SV(I)-20190033) and the Institutional Review Board of Tri-Service General Hospital (IRB: TSGHIRB 2-107-05-080).
Conflict-of-interest statement: No author had reported a potential conflict of interest relevant to this work.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ming-Lung Yu, MD, PhD, Adjunct Professor, Chief Doctor, Full Professor, Division of Hepatobiliary, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, No. 100 Shin-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan. fish6069@gmail.com
Received: August 5, 2021
Peer-review started: August 5, 2021
First decision: November 7, 2021
Revised: November 17, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: January 14, 2022
ARTICLE HIGHLIGHTS
Research background
Prisoners are at high risk of hepatitis C virus (HCV) infection. To screen and treat HCV infection in prisoners is an important social health issue. It can be the start for HCV micro-elimination.
Research motivation
HCV treatment is not frequently administered to prisoners due to multiple factors. Therefore, we implemented an outreach strategy in combination with universal mass screen and onsite treatment in a prison.
Research objectives
To implement an outreach strategy. HCV-infected prisoners received a simplified pan-genotypic direct-acting antivirals (DAA) regimen, 12 wk of sofosbuvir/velpatasvir. The primary endpoint was sustained virological response (SVR12, defined as undetectable HCV RNA throughout 12 wk of the post-treatment follow-up period).
Research methods
All participants received blood tests. We used reflex testing. All HCV-infected prisoners received DAA therapy. Laboratory data monitoring and assessment of side effects were performed at treatment wk 2, 4, 8 and end-of-treatment (EOT), and 12 wk after EOT.
Research results
DAA regimen with sofosbuvir/velpatasvir achieved high SVR12 rate. There was no virological failure, treatment discontinuation, and serious adverse event among sofosbuvir/velpatasvir-treated patients in the HCV micro-elimination group.
Research conclusions
Well-designed strategies for mass screening and treatment for HCV-infected prisoners can be implemented successfully by the collaboration between physicians and prison authorities.
Research perspectives
Our study provided evidence for the concept that simplified, genotyping/subtyping-free regimens can achieve high SVR12 rate in HCV-infected prisoners. In the future, it is possible to implement the strategy to all prisoners in our country.
