Published online Sep 28, 2015. doi: 10.4254/wjh.v7.i21.2323
Peer-review started: April 24, 2015
First decision: July 25, 2015
Revised: August 5, 2015
Accepted: September 7, 2015
Article in press: September 8, 2015
Published online: September 28, 2015
The studies on hepatitis C virus (HCV) infection in prison populations are few and mostly cross-sectional. We analyzed prevalently the articles appearing on PubMed in the last ten years. HCV infection is frequent in prisoners, prevalences ranging from 3.1% to 38% according to the HCV endemicity in the geographical location of the prison and in the countries of origin of the foreign prisoners and to the prevalence of intravenous drug use, which is the most important risk factor for HCV infection, followed by an older age of prisoners and previous prison terms. HCV replication in anti-HCV-positive cases varies from 45% to 90% in different studies, and the most common HCV genotypes are generally 1 and 3. The response to antiviral treatment is similar in prisoners to that of the general population. Unfortunately, treatment is administered less frequently to prisoners because of the difficulties in management and follow-up. The new directly acting antivirals offer a good therapy option for inmates because of their good efficacy, short duration of treatment and low incidence of side effects. The efforts of the prison authorities and medical staff should be focused on reducing the spread of HCV infection in prisons by extending the possibility of follow-up and treatment to more prisoners with chronic hepatitis C.
Core tip: Hepatitis C virus (HCV) infection in prisoners is a social health problem: It is more frequent than in the general population, but access to proper management and treatment is more difficult. In this setting HCV infection can be easily transmitted due to overcrowded conditions, sharing supplies and particularly by drug use. In the past, HCV treatment was rarely administered to prisoners, often because they did not stay in the same structure long enough. Also, the risk of HCV re-infection is high in inmates. New policies should be applied to guarantee prisoners the same care as the general population, particularly in view of the new, shorter and more effective anti-HCV treatments.