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Rev Esp Enferm Dig. 2019 Jul;111(7):550-555. doi: 10.17235/reed.2019.6152/2018.

The contribution of telemedicine to hepatitis C elimination in a correctional facility.

Author information

1
Servicio Medico, Centro Penitenciario Madrid IV, Centro Penitenciario de Navalcarnero, España.
2
Servicio Medico, Centro Penitenciario Madrid IV, Centro Penitenciario de Navalcarnero, Spain.
3
Unidad de Acceso restringido, Hospital General Universitario Gregorio Marañón, Spain.
4
Digestivo, Hospital Universitario Fundacion Alcorcon, España.
5
Servicio de Enfermedades Digestivas, Hospital Universitario Fundación Alcorcón.
6
Aparato Digestivo, Hospital Universitario Fundacion Alcorcon, Spain.
7
Unidad de infecciosas. Medicina Interna, Hospital Universitario Fundación Alcorcón, Spain.
8
Unidad de Infecciosas. Medicina Interna, Hospital Universitario Fundacion Alcorcon, Spain.
9
Medicina Interna, Hospital Universitario Fundación Alcorcón, Spain.
10
Enfermedades Infecciosas, Hospital Universitario Fundación Alcorcón, Spain.
11
Unidad de Microbiologia, Hospital Universitario Fundación Alcorcón, Spain.
12
Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Spain.

Abstract

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.

PMID:
31215210
DOI:
10.17235/reed.2019.6152/2018
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