final program.qxd - Parallels Plesk Panel

PP 5.8
Management of Chronic hepatitis C with Pegylated Interferon and Ribavirin in a
Prison Setting
Sergio Sabbatani, Ruggero Giuliani, Roberto Manfredi
Infectious Diseases, University of Bologna, Italy
Introduction
The elevated frequency of chronic HCV infection found among prison inmates, and the
availability of improved pharmacological cure for this potentially life-threatening disorder,
make the investigations conducted in this somewhat neglected area very promising, since
only a few, open-label experiences are recorded until now.
Patients, Methods, and Results
In a serological survey conducted in the metropolitan prison of Bologna (Italy), HCV seroprevalence
was recognised over 31% in the year 2003, so that a pilot feasibility study
based on treatment with associated pegylated interferon plus ribavirin was initiated, after
a careful counselling carried out by joined health care personnel of the correctional
facility and Infectious Diseases consultants. Thirty-nine patients were enrolled, and
despite expected drop-outs due to difficulty in maintaining the same counselling pressure
during time, and the particularly unfavorable climatic conditions occurred in Summer 2003,
a sustained virological response was obtained in 8 out of 21 patients who remained
evaluable after the first three month of follow-up (38.1%), although we have to take into
account that a relevant percentage of subjects (66.7%) were selected for therapy due to
their favorable HCV genotypes (types 2 and 3).
Conclusions
Our preliminary experience shows that an intrinsecally complicated therapy such as the
administation of pegylated interferon plus ribavirin, may be conducted with a
proportionally elevated success rate also in a very unfavorable and unconfortable context,
such as a prison, where only enforced counselling, active participation of internal health
care operators, and patient's willingness maintaing an elevated level of co-operation and
adherence, can overcome most of structural and relational difficulties typical of this
difficult setting.
POSTERS
“ Focusing FIRST on PEOPLE “ 215 w w w . i s h e i d . c o m